Retinal neurovascular characteristics for the diagnosis and staging of nondiabetic chronic kidney disease: a diagnostic study

Retinal neurovascular characteristics for the diagnosis and staging of nondiabetic chronic kidney disease: a diagnostic study

:371-388
 
Aims: To identify the characteristic retinal neurovascular changes in patients in different stages of nondiabetic chronic kidney disease (CKD) and to develop a model for the accurate diagnosis of nondiabetic CKD.
Methods: Peripapillary retinal nerve fiber layer (pRNFL) thickness and average macular ganglion cell-inner plexiform layer (GC-IPL) thickness of nondiabetic CKD patients and healthy controls (HC) were evaluated by spectral-domain optical coherence tomography (OCT). The vessel density (VD) and perfusion density (PD) of the macula were obtained from optical coherence tomography angiography (OCTA). The estimated glomerular filtration rate (eGFR) was obtained to access the kidney function of CKD patients. Multiple linear regression models were used to adjust for confounding factors in statistical analyzes. The diagnostic capabilities of the parameters were evaluated by logistic regression models.
Results: 131 nondiabetic CKD patients and 62 HC 
entered the study. eGFR was found significantly associated with parafoveal VD and PD (average PD: β = 0.000 4, Padjusted < 0.001) in various sectors. Thinning of pRNFL (β = -6.725, Padjusted0.001) and GC-IPL (β = -4.542, Padjusted < 0.001), as well as decreased VD (β = -2.107, P- adjusted0.001) and PD (β = -0.057, Padjusted = 0.0328) were found in CKD patients. Thinning of pRNFL and deteriorated perifoveal vasculature were found in early CKD, and the parafoveal and foveal VD significantly declined in advanced CKD. Logistic regression models were employed, and selected neurovascular parameters showed an AUC of 0.853 (95% Confidence Interval [CI]: 0.795 to 0.910) in distinguishing CKD patients from HC.
Conclusions: Distinctive retinal neurovascular 
characteristics could be observed in nondiabetic CKD patients of different severities. Our results suggest that retinal manifestations could be valuable in the screening, diagnosis, and follow-up evaluation of patients with CKD.
Aims: To identify the characteristic retinal neurovascular changes in patients in different stages of nondiabetic chronic kidney disease (CKD) and to develop a model for the accurate diagnosis of nondiabetic CKD.
Methods: Peripapillary retinal nerve fiber layer (pRNFL) thickness and average macular ganglion cell-inner plexiform layer (GC-IPL) thickness of nondiabetic CKD patients and healthy controls (HC) were evaluated by spectral-domain optical coherence tomography (OCT). The vessel density (VD) and perfusion density (PD) of the macula were obtained from optical coherence tomography angiography (OCTA). The estimated glomerular filtration rate (eGFR) was obtained to access the kidney function of CKD patients. Multiple linear regression models were used to adjust for confounding factors in statistical analyzes. The diagnostic capabilities of the parameters were evaluated by logistic regression models.
Results: 131 nondiabetic CKD patients and 62 HC 
entered the study. eGFR was found significantly associated with parafoveal VD and PD (average PD: β = 0.000 4, Padjusted < 0.001) in various sectors. Thinning of pRNFL (β = -6.725, Padjusted < 0.001) and GC-IPL (β = -4.542, Padjusted < 0.001), as well as decreased VD (β = -2.107, Padjusted < 0.001) and PD (β = -0.057, Padjusted = 0.0328) were found in CKD patients. Thinning of pRNFL and deteriorated perifoveal vasculature were found in early CKD, and the parafoveal and foveal VD significantly declined in advanced CKD. Logistic regression models were employed, and selected neurovascular parameters showed an AUC of 0.853 (95% Confidence Interval [CI]: 0.795 to 0.910) in distinguishing CKD patients from HC.
Conclusions: Distinctive retinal neurovascular 
characteristics could be observed in nondiabetic CKD patients of different severities. Our results suggest that retinal manifestations could be valuable in the screening, diagnosis, and follow-up evaluation of patients with CKD.
病例报告

混合型永存胚胎血管1例

Combined persistent fetal vasculature: A case report

:679-684
 
永存胚胎血管(persistent fetal vasculature,PFV),也称永存原始玻璃体增生症( persistent hyperplastic primary vitreous,PHPV),是一种先天性眼病,多发现于婴幼儿时期。因大多数患儿单眼发病、症状隐匿,且易被误诊为单纯的先天性白内障,常常延误手术治疗的最佳时机。因此,正确的诊断和适宜治疗方式的选择对于患儿视功能的预后尤为重要。本文报道了1例6岁6个月的男性患儿,诊断为混合型PFV,眼部特征表现为先天性白内障和黄斑区结构错位。
Persistent fetal vasculature (PFV), also known as persistent hyperplastic primary vitreous (PHPV), is a congenital ocular anomaly, which is common in infants and young children. Due to most children have unilateral occurrence, insidious symptoms and are easily misdiagnosed as simple congenital cataract, the optimum time for treatment is often delayed. Therefore, correct diagnosis and appropriate treatment are particularly significant for the prognosis of PFV children’s visual function. A male child aged 6 years and 6 months with a diagnosis of combined PFV is reported, whose ocular features were congenital cataract and structural dislocation of macula.
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