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Subject Area

Ophthalmology

Article Type

Original Study

Abstract

Background The eye shares striking structural, developmental, and genetic pathways with the kidney, suggesting that kidney disease and ocular disease may be closely linked. Objectives To assess retinal and choroidal thickness in patients with chronic kidney disease (CKD) using spectral-domain optical coherence tomography. Patients and methods This was a cross-sectional study conducted at Menoufia University Hospital Ophthalmology Department on 144 eyes of 72 CKD patients, who were divided into three groups according to the stage of CKD as follows: group 1: CKD stage 1–2, estimated glomerular filtration rate (eGFR) more than 60 ml/min/1.73m2, group 2: CKD stage 3, eGFR 30–59 ml/min/1.73m2, and group 3: CKD stage 4–5, eGFR less than 29 ml/min/1.73m2. Each subject underwent a full ophthalmologic examination followed by optical coherence tomography assessment of retinal, retinal nerve fiber layer, and choroidal thickness. The procedure was achieved with pupillary dilatation. Results Retinal thickness and choroidal thickness were reduced in group 2 and group 3 compared with group 1 (for retinal thickness P = 0.015 for group 3 vs. group 1 and P = 0.022 for group 2 vs. group 1; for choroidal thickness P < 0.001 for group 2 and group 3 vs. group 1). This reduction was more in group 3 than in group 2. Conclusion This study revealed that chorioretinal thinning in CKD is associated with a lower eGFR, a higher serum C-reactive protein, and greater proteinuria. Larger studies, in more targeted groups of patients, are now needed to clarify whether these eye changes reflect the natural history of CKD. Similarly, associations with arterial stiffness, inflammation, and endothelial dysfunction warrant further examination.

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