May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Prevalence of Fundus Pathology in the Chronic Renal Insufficiency Cohort (CRIC) Study
Author Affiliations & Notes
  • J. E. Grunwald
    Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania
  • J. Alexander
    Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania
  • R. Whittock
    Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania
  • K. McWilliams
    Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania
  • C. A. Gadegbeku
    Medicine, University of Michigan, Ann Arbor, Michigan
  • J. P. Lash
    Medicine, University of Illinois, Chicago, Illinois
  • J. C. Lo
    Medicine, Kaiser Permanente Northern California, Oakland, California
  • R. Townsend
    Medicine, University of Pennsylvania Medical School, Philadelphia, Pennsylvania
  • CRIC Study Group
    Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania
  • Footnotes
    Commercial Relationships  J.E. Grunwald, None; J. Alexander, None; R. Whittock, None; K. McWilliams, None; C.A. Gadegbeku, None; J.P. Lash, None; J.C. Lo, None; R. Townsend, None.
  • Footnotes
    Support  NIDDK grant DK074151, Vivian S. Lasko Research Fund, Nina C. Mackall Trust, Research to Prevent Blindness
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 2148. doi:https://doi.org/
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      J. E. Grunwald, J. Alexander, R. Whittock, K. McWilliams, C. A. Gadegbeku, J. P. Lash, J. C. Lo, R. Townsend, CRIC Study Group; Prevalence of Fundus Pathology in the Chronic Renal Insufficiency Cohort (CRIC) Study. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2148. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To describe the prevalence of fundus pathology in the CRIC study, a multi-center longitudinal study of individuals with chronic kidney disease (CKD) followed for CKD progression and cardiovascular (CVD) events.

Methods: : During a CRIC annual examination, 45º digital photos of the disc and macula were obtained by non-ophthalmologic personnel using a non-mydriatic Cannon CR-Dgi fundus camera. Photographs were obtained in 1613 patients participating in 6 CRIC centers and were assessed in a masked fashion by a retinal specialist. The purpose of this review was to quickly inform patients of the need for a complete eye examination by an ophthalmologist. Mean age was: 58±11 years (± 1SD), range 21-75 years; mean systolic blood pressure: 127±21 mmHg, range 73-243 mmHg; mean diastolic pressure: 72±13 mmHg, range 35-139 mmHg; estimated mean glomerular filtration rate: 44.9±13.7 mL/min/1.73m2 ; range 13.5-93.6 mL/min/1.73m2. Racial distribution was: 50% Caucasian, 44.8% African American and 5.2% other. 54.3% of the participants were male. Systemic hypertension was present in 83.7%, and diabetes mellitus was present in 44.2% of the subjects.

Results: : Among the 1613 patients reviewed, 721 (45%) patients required a follow up examination by an ophthalmologist because of mild to severe pathologic fundus findings. Retinopathy (diabetic and/or hypertensive) was observed in 373 (23%) patients. Optic disc cup-to-disc ratio larger than 0.7 was observed in 144 (9%) patients. Age related macular degeneration and drusen were detected in 127 (8%) patients. Miscellaneous abnormal findings such as pigmentary changes and vitreous opacities were seen in 94 (6%) patients. Nevi were observed in 19 (1%) patients. Embolic plaques were seen in 7 patients. In 7% (50 patients) of the 721 patients with fundus abnormalities we found serious eye conditions, such as diabetic retinopathy (40 patients) and others (10 patients), that required urgent follow up.

Conclusions: : Our results show a high prevalence of fundus pathology suggesting that these patients should receive a complete eye examination. Quantitative assessment of retinopathy and retinal vascular calibers in this study will further elucidate the relationship between retinal vascular changes and CKD and CVD.

Keywords: imaging/image analysis: clinical • diabetic retinopathy • clinical (human) or epidemiologic studies: prevalence/incidence 
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