Background: Chronic kidney disease (CKD) destroys kidney function over months or years, resulting in end-stage renal disease (ESRD) and contributing greatly to morbidity and mortality. The accumulation of toxins, inflammation, and reduced blood flow in CKD affects the nervous system, circulatory system, and even the eyes. The retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC), being prone to the shortage of blood, are good markers for evaluating the health of the retina in diseases such as CKD. This can, in turn, aid in determining the prognosis and modifying treatment modalities in individual patients. Purpose: To measure the RNFL and GCC thickness in patients with CKD and compare these measurements with those in age-matched healthy controls. Methods: This comparative cross-sectional study included 100 patients with CKD and 100 age-matched healthy controls. A comprehensive ocular examination was performed for all, including best-corrected visual acuity (BCVA), intraocular pressure (IOP), and fundus assessment. Optical coherence tomography (OCT) was performed in all cases. We measured RNFL thickness (RNFLT) and GCC in all quadrants. The duration of CKD and serum urea and creatinine levels were noted. We used Pearson’s coefficient and multivariate analysis to examine the association between the parameters, with a p-value of <0.05 considered significant. Results: The mean age was 39.39 years in the CKD group and 38.26 years in the control group. The differences in BCVA and cup-disc ratio (CDR) between the two groups were statistically significant. The mean BCVA in the control group was statistically better than that in the CKD group. The mean IOP was 11.95 ± 1.45 mmHg in the CKD group, whereas it was 15.41 ± 3.55 mmHg in the control group. The difference in RNFLT in all quadrants was statistically significant between the two groups, except in the superior quadrant. The thickness of GCC was greater in all quadrants in the control group, whereas the difference in thickness between the groups was statistically significant in all quadrants except in the inferior quadrant. Conclusion: Substantial structural and functional alterations in the eye are present in moderate-to-severe CKD, even when elevated IOP is not present, effectively establishing a relationship between changes in the RNFL and GCC with renal function.
Sahu et al. (Thu,) studied this question.