Abstract
Purpose :
To our knowledge, very few studies have been conducted to better understand the impact of end-stage renal disease (ESRD) on retinal health, which could aid in the development of targeted therapies to improve patient care. We conducted a cross-sectional, observational clinical study in a tertiary care eye center in Nepal to explore changes in the retinal nerve fiber layer (RNFL) and color contrast among patients with ESRD of various durations.
Methods :
Patients between the ages of 18 and 60 with a diagnosis of ESRD (defined as GFR < 15 mL/min/1.73 m2) were included. Exclusion criteria comprised any pre-existing ocular conditions, including diabetic or hypertensive retinopathy and glaucoma. 64 patients (male: 43, female: 21) with 128 eyes qualified for the study. The Pelli Robson Chart was administered to evaluate color contrast. Then, the patient's RNFL thickness in various quadrants was obtained using Heidelberg Spectral-Domain OCT. These values were recorded along with the patient's number of years since the diagnosis of ESRD. The RNFL thickness was found to be normally distributed and was compared to normative data of the Nepalese population using a one-sample T-test. Finally, Pearson correlation was applied to (a) RNFL thickness and ESRD chronicity, and (b) color contrast and ESRD chronicity.
Results :
RNFL Thickness:
Patients with ESRD had a statistically significant reduction of RNFL thickness in superior and inferior quadrants when compared to Nepalese normative data (Table 1).
ESRD, RNFL Thickness, and Color Contrast
A negative correlation was found between RNFL thickness (superior r=-0.373 p<0.001 and inferior r= -0.278 p=0.002 and chronicity of ESRD (Figure 1).
A strong negative correlation (r=-0.861 p<0.01) was found between color contrast and chronicity of ESRD (Figure 1)
Conclusions :
When compared to normative data, patients with ESRD have reduced RNFL thickness. The longer the chronicity of ESRD, the higher the reduction in RNFL thickness and color contrast. This implies a possible ongoing optic-nerve involving neurodegeneration in patients with ESRD.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.