Correlation between Renal Function and Peripapillary Choroidal Thickness in Treatment-Naïve Diabetic Eyes Using Swept-Source Optical Coherence Tomography

ABSTRACT

Purpose: To investigate the associations of the estimated glomerular filtration rate (eGFR) with peripapillary choroidal thickness (pCT) and retinal nerve fiber layer (pRNFL) thickness in diabetic patients by using swept-source optical coherence tomography (SS-OCT).

Methods: Ocular treatment-naïve patients with type 2 diabetes mellitus registered in the community health system in Guangzhou, China, were recruited to participate in this prospective cross-sectional study. The eGFR was determined using the Xiangya formula, and the renal function was categorized into non-chronic kidney disease (non-CKD), mild CKD, and moderate to severe CKD (MS-CKD) according to the guidelines. The pCT and pRNFL thicknesses at 12 o’clock were obtained using an SS-OCT by a circular scan with a diameter of 3.4 mm centering on the optic nerve head, and the data from only one eye in each patient were used.

Results: This study included 1,408 diabetic patients, with a mean age of 64.4 ± 7.8 years. The average pCT decreased with renal function deterioration, with 126.0 ± 58.0 μm for non-CKD, 112.0 ± 51.2 μm for mild CKD and 71.0 ± 22.9 μm for MS-CKD, respectively (P < .001). The pCT was found to be significantly thinner in CKD patients in all quadrantes (P < .05 in all regions) with the exception of the inferior quadrant, and the average pCT was positively correlated with eGFR (β = 0.3, 95%CI = 0.0 to 0.6, P = .021) after adjusting for other factors. The pRNFL thickness in the nasal quadrant was significantly reduced in patients with CKD, and pRNFL thickness was positively correlated with eGFR (β = 0.1, 95%CI = 0.0–0.2, P = .009) after adjusting for other factors.

Conclusion: Impaired renal function was associated with a reduction of pCT and pRNFL thickness in patients with type 2 diabetes. The measurement of pCT and pRNFL may provide additional information for predicting renal impairment.

KEYWORDS:

• Diabetes mellitus
• swept-source optical coherence tomography
• peripapillary choroidal thickness
• renal function

Author contributions

WW and WH had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: WW, WL, MH, WH.

Acquisition, analysis, or interpretation of data: LS, DZ, YT, YL, WL.

Drafting of the manuscript: LS, DZ, WW.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: WW.

Obtained funding: WH.

Administrative, technical, or material support: MH, WW.

Study supervision: MH.

Declaration of competing interest

All authors declare no conflicts of interest related to this study.

Data sharing statement

The data used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This study was supported by the National Natural Science Foundation of China [81570843; 81530028; 81721003]; and the Guangdong Province Science & Technology Plan [2014B020228002].