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RESEARCH PRODUCT

Retinal and choroidal vasculature changes associated with chronic kidney disease

Giulia GuarrasiTiziana La BlascaMassimo CastellucciGiuseppe MulèMicol TerrasiMaria Vadalà

subject

Male030204 cardiovascular system & hematologyurologic and male genital diseaseschemistry.chemical_compound0302 clinical medicineFluorescein AngiographyMiddle Agedfemale genital diseases and pregnancy complicationsSensory Systemschoroidal thickness chronic kidney disease vascular density retinal thickness swept source OCTA swept source OCT angiographyHypertensionDisease ProgressionFemalemedicine.symptomTomography Optical CoherenceAdultmedicine.medical_specialtyAdolescentFundus OculiRenal function03 medical and health sciencesCellular and Molecular NeuroscienceYoung AdultRetinal DiseasesOphthalmologymedicineHumansRenal Insufficiency ChronicRetinal thinningAgedRetrospective StudiesSettore MED/14 - Nefrologiabusiness.industryChoroidSettore MED/30 - Malattie Apparato VisivoRetinal VesselsRetinalmedicine.diseaseeye diseasesOphthalmologyBlood pressureCross-Sectional StudieschemistryBlood chemistry030221 ophthalmology & optometryAlbuminuriaMicroalbuminuriasense organsbusinessKidney disease

description

Retinal and choroidal microvascular changes can be related to renal impairment in hypertension and chronic kidney disease (CKD). The study examines the association between retinochoroidal parameters and renal impairment in hypertensive, non-diabetic patients. This is a cross-sectional study on Caucasian patients with systemic arterial hypertension with different levels of renal function. All subjects were studied by blood chemistry, urine examination, microalbuminuria and blood pressure. Complete eye examination was completed with swept source optical coherence tomography (SS-OCT) and optical coherence tomography angiography (OCTA) scans of macular region. Patients were divided in groups: LowGFR and HighGFR and CKD− and CKD+, according to the value of glomerular filtrate (GFR) and albuminuria. LowGFR and CKD+ groups included patients with clinical kidney impairment. One hundred and twenty eyes of 120 hypertensive patients were evaluated. The mean retinal thickness was thinner in CKD+ versus CKD− group (p < 0.009). LowGFR and CKD+ groups showed thinner choroidal values than HighGFR (p < 0.02) and CKD− (p < 0.001) groups. OCTA showed lower density in LowGFR than in HighGFR group (p < 0.001) and in CKD+ versus CKD− group (p < 0.001). Albuminuria was inversely related to choroidal and retinal thickness measures (p < 0.001) and to the indices of superficial parafoveal (p < 0.05) and foveal (p < 0.05) vascular densities. CKD is associated with retinal thinning, eGFR and decreasing renal function with progressive reduction of choroidal and retinal vascular density. SS-OCT and OCTA documented close association between CKD and reduction of both choroidal thickness and paracentral retinal vascular density in hypertensive patients.

yearjournalcountryeditionlanguage
2018-11-17
10.1007/s00417-019-04358-3http://hdl.handle.net/10447/362992