Association of chorioretinal thickness with chronic kidney disease

Abstract

Abstract Objective To assess retinal and choroidal thickness changes in chronic kidney disease (CKD) patients using spectral domain optical coherence tomography (SD-OCT). Background CKD is a devastating health trouble. The eye and the kidney share similar structural and genetic pathways, so that kidney disease and ocular disease may be closely linked. OCT is a precise, fast method for high-definition scanning of the retina and choroid. Patients and methods A cross sectional study was conducted at Menoufia University Hospital ophthalmology department on 144 eyes of 72 CKD patients divided into 3 groups according to the stage of CKD as follows: group 1: CKD stage 1–2, with Glomerular Filtration Rate (GFR) > 60 ml/min/1.73m2 group 2: CKD stage 3, GFR 30–59 ml/min/1.73m2 and group 3: CKD stage 4–5, eGFR < 29 ml/min/1.73m2. All patients underwent full ophthalmologic examination followed by OCT assessment of retinal, retinal nerve fiber layer (RNFL) and choroidal thickness. Results Retinal and choroidal thickness were reduced in group 2 (CKD stage 3) and group 3 (CKD stage 4–5) compared with group 1 (CKD stage 1–2). The reduction was more severe in group 3 than group 2. RNFL thickness did not differ between groups. A thinner retina and choroid were associated with an elevated serum C-reactive protein (CRP) concentration, and greater degrees of proteinuria. Conclusion Chorioretinal thinning in CKD is associated with a lower eGFR, a higher CRP, and greater proteinuria. Further studies, in a large scale of patients, are needed to detect whether these eye changes reflect the natural history of CKD.