June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
An eye on kidney disease: the association of vascular retinal markers with chronic kidney disease in the Eye Determinants of Cognition (EyeDOC) Study
Author Affiliations & Notes
  • Alison Abraham
    Johns Hopkins School of Medicine, Baltimore, Maryland, United States
    Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Johannes Scheppach
    Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Xinxing Guo
    Johns Hopkins School of Medicine, Baltimore, Maryland, United States
  • A. Richey Sharrett
    Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Lubaina Arsiwala
    Johns Hopkins School of Medicine, Baltimore, Maryland, United States
  • Yanan Dong
    Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • David Huang
    Casey Eye Institute, Oregon, United States
  • Brandon J Lujan
    Casey Eye Institute, Oregon, United States
  • Liang Liu
    Casey Eye Institute, Oregon, United States
  • Qisheng You
    Casey Eye Institute, Oregon, United States
  • Yali Jia
    Casey Eye Institute, Oregon, United States
  • Alexander Tomlinson
    Casey Eye Institute, Oregon, United States
  • Pradeep Y Ramulu
    Johns Hopkins School of Medicine, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   Alison Abraham, None; Johannes Scheppach, None; Xinxing Guo, None; A. Richey Sharrett, None; Lubaina Arsiwala, None; Yanan Dong, None; David Huang, Optovue, Inc (F), Optovue, Inc (I), Optovue, Inc (P), Optovue, Inc (R); Brandon Lujan, None; Liang Liu, None; Qisheng You, None; Yali Jia, Optovue, Inc (F), Optovue, Inc (P); Alexander Tomlinson, None; Pradeep Ramulu, Aerie Pharmaceuticals (C), Perfuse Therapeutics (C), W.L.Gone (C)
  • Footnotes
    Support  NIH Grant AG052412
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 5148. doi:
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      Alison Abraham, Johannes Scheppach, Xinxing Guo, A. Richey Sharrett, Lubaina Arsiwala, Yanan Dong, David Huang, Brandon J Lujan, Liang Liu, Qisheng You, Yali Jia, Alexander Tomlinson, Pradeep Y Ramulu; An eye on kidney disease: the association of vascular retinal markers with chronic kidney disease in the Eye Determinants of Cognition (EyeDOC) Study. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5148.

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

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Abstract

Purpose : The eye and the kidney share vascular features, and a number of studies have found associations between kidney and eye diseases. Here we examined the association of retinal vessel density (VD) with concurrent indicators of kidney health in an aging population-based bi-racial sample

Methods : The EyeDOC study used optical coherence tomography angiography (OCTA) to capture macular retinal vascular features in a 6 X 6 mm2 area. VD (% of area covered by vessels) in the superficial vascular complex [SVC], intermediate capillary plexus [ICP] and deep capillary plexus [DCP]. Glomerular filtration rate was estimated from serum creatinine (ScGFR; Levey et al., 2009) and seperately from Cystatin (CysGFR; Inker et al., 2012). In a cross-sectional analysis, VD was regressed on ScGFR and CysGFR using robust variance estimation and controlling for sex, age, race and image Signal Strength Index (SSI). Both ScGFR and CysGFR were expressed categorically using standard CKD thresholds (<45, 45-<60, 60-<90, >=90 ml/min). Secondary analyses were restricted to participants with diabetes.

Results : Among 519 eyes from 489 participants (43% black; 61% female; mean age 78 years [range: 71-93 years]), 37% had diabetes and 28% had prevalent CKD(ScGFR<60 ml/min). In univariate analysis, the distribution of VD was generally similar across strata of ScGFR and CysGFR except for those in the higher GFR category (Figure). In the full sample, regression analysis indicated that those with ScGFR or CysGFR >=90 ml/min had generally lower VD compared to those with lower GFR levels across all layers (Table). Differences were more pronounced with CysGFR; VD in ICP and DCP was approximately 2% higher for those with CysGFR<60 ml/min compared to those with CysGFR>=90 ml/min (P=0.05). In the 192 diabetic participants, results varied across the layers and between ScGFR and CysGFR.

Conclusions : Results do not suggest that poorer kidney function is related to vascular health in the retina, though there was some suggestion that those in the highest GFR group were at risk for lower VD contrary to expectation. Higher levels of GFR above 90 ml/min can arise from hyperfiltration, a precursor to kidney function decline. Further work could assess additional indicators of kidney disease such as proteinuria.

This is a 2020 ARVO Annual Meeting abstract.

 

Regression analysis results

Regression analysis results

 

Distribution of VD in the SVC and DCP across categories of ScGFR

Distribution of VD in the SVC and DCP across categories of ScGFR

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