Retinal and choroidal vasculature changes associated with chronic kidney disease

Vadalà, Maria; Castellucci, Massimo; Guarrasi, Giulia; Terrasi, Micol; Blasca, Tiziana La; Mulè, Giuseppe

doi:10.1007/s00417-019-04358-3

Cited by 70 publications

(86 citation statements)

References 30 publications

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“…The pathophysiological mechanism of thinning CT in patients with renal impairment in this study may share common pathways with DM and hypertension. 7,8,32,33 The association of eGFR and CT were also reported in previous studies based on nondiabetic patients. Vadalà et al 33 found that decreasing CT was significantly associated with decreasing eGFR and defects of renal function in patients with essential hypertension.…”

Section: Discussionsupporting

confidence: 76%

“…7,8,32,33 The association of eGFR and CT were also reported in previous studies based on nondiabetic patients. Vadalà et al 33 found that decreasing CT was significantly associated with decreasing eGFR and defects of renal function in patients with essential hypertension. Mulè et al 8 reported that eGFR was directly correlated with CT independent of age and other confounding factors, and the poorer the renal function, the thinner the CT.…”

Section: Discussionsupporting

confidence: 76%

“…However, the value of OCT parameters in predicting renal function needs to be verified in future research with larger populations. 6,33,34 There was double-digit difference in the number of the patients between the groups. If the group with renal impairment had significantly severe DR, the data were skewed because the number of patients with renal impairment was quite small compared with the other.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Relationship Between Renal Function and Choroidal Thickness in Type 2 Diabetic Patients Detected by Swept-Source Optical Coherence Tomography

Liu

Wang

Tan

et al. 2020

Trans. Vis. Sci. Tech.

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show abstract

Section: Discussionsupporting

confidence: 76%

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Relationship Between Renal Function and Choroidal Thickness in Type 2 Diabetic Patients Detected by Swept-Source Optical Coherence Tomography

Liu

Wang

Tan

et al. 2020

Trans. Vis. Sci. Tech.

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show abstract

“… 15 Mule et al also described a correlation between ChT and renal function in patients with hypertension. 24 , 25 The findings of the present study are consistent with those of previous studies, although the correlation between ChT and renal function has rarely been described in patients with diabetes or DR. Abnormality in mineral metabolism occurs from the early stage of CKD. 26 Phosphorus is mainly excreted by the kidneys in normal conditions.…”

Section: Discussionsupporting

confidence: 93%

Effects of Systemic Profiles on Choroidal Thickness in Treatment-Naïve Eyes With Diabetic Retinopathy

Choi

Chung

Yoon

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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Purpose The purpose of this study was to analyze the effects of systemic and ocular profiles on subfoveal choroidal thickness (SFChT) in treatment-naïve eyes with diabetic retinopathy (DR). Methods This study included patients with treatment-naïve DR. They underwent routine laboratory evaluations, including complete blood cell count, liver function tests, kidney function tests, and urinalysis for macroalbuminuria. The systemic and ocular factors associated with the change in SFChT in DR were analyzed. Results A total of 136 eyes from 136 patients with diabetes and 30 eyes from 30 age-matched healthy controls were recruited. Generalized linear model analyses showed that the SFChT in treatment-naïve eyes with DR was positively associated with the DR grade and estimated glomerular filtration rate (eGFR; P = 0.001) and negatively associated with age ( P < 0.001) and serum phosphorus levels ( P = 0.001). Treatment-naïve eyes with proliferative DR (PDR; 313.4 ± 9.0 µm) or severe nonproliferative DR (NPDR; 299.7 ± 9.7 µm) had thicker choroid than eyes with mild to moderate NPDR (251.7 ± 11.1 µm) or no DR (231.2 ± 14.5 µm) after adjusting for age, eGFR, and phosphorus levels. Conclusions Choroid is affected by renal function and the grade of DR in patients with diabetes. Advanced retinopathy is associated with choroidal thickening, and the severity of concomitant renal disease is associated with choroidal thinning.

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“…110 An Italian study extended these findings by using OCT-A in 120 hypertensive patients with and without CKD to report a lower vessel density in both superficial and deep capillary plexuses in those with CKD. 134 The inclusion of patients with more severe renal impairment and higher proteinuria in this study 134 may explain the more extensive retinal vessel rarefaction seen as compared with the Singapore study. 110 However, it is important to note that different OCT-A devices were used by each center.…”

Section: Oct Angiographymentioning

confidence: 85%

The eye, the kidney, and cardiovascular disease: old concepts, better tools, and new horizons

Farrah

Dhillon

Keane

et al. 2020

Kidney International

104

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Chronic kidney disease (CKD) is common, with hypertension and diabetes mellitus acting as major risk factors for its development. Cardiovascular disease is the leading cause of death worldwide and the most frequent end point of CKD. There is an urgent need for more precise methods to identify patients at risk of CKD and cardiovascular disease. Alterations in microvascular structure and function contribute to the development of hypertension, diabetes, CKD, and their associated cardiovascular disease. Homology between the eye and the kidney suggests that noninvasive imaging of the retinal vessels can detect these microvascular alterations to improve targeting of at-risk patients. Retinal vessel–derived metrics predict incident hypertension, diabetes, CKD, and cardiovascular disease and add to the current renal and cardiovascular risk stratification tools. The advent of optical coherence tomography (OCT) has transformed retinal imaging by capturing the chorioretinal microcirculation and its dependent tissue with near-histological resolution. In hypertension, diabetes, and CKD, OCT has revealed vessel remodeling and chorioretinal thinning. Clinical and preclinical OCT has linked retinal microvascular pathology to circulating and histological markers of injury in the kidney. The advent of OCT angiography allows contrast-free visualization of intraretinal capillary networks to potentially detect early incipient microvascular disease. Combining OCT’s deep imaging with the analytical power of deep learning represents the next frontier in defining what the eye can reveal about the kidney and broader cardiovascular health.

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Retinal and choroidal vasculature changes associated with chronic kidney disease

Cited by 70 publications

References 30 publications

Relationship Between Renal Function and Choroidal Thickness in Type 2 Diabetic Patients Detected by Swept-Source Optical Coherence Tomography

Relationship Between Renal Function and Choroidal Thickness in Type 2 Diabetic Patients Detected by Swept-Source Optical Coherence Tomography

Effects of Systemic Profiles on Choroidal Thickness in Treatment-Naïve Eyes With Diabetic Retinopathy

The eye, the kidney, and cardiovascular disease: old concepts, better tools, and new horizons

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