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Abstract: TH-PO323

Comparison of Retinal Neurodegenerative Changes in Patients with CKD Undergoing Hemodialysis versus Healthy Controls Assessed by Spectral-Domain Optical Coherence Tomography

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Jung, Susanne, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
  • Bosch, Agnes, University Hospital Erlangen, Erlangen, Germany
  • Ott, Christian, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
  • Kannenkeril, Dennis, University Hospital Erlangen, Erlangen, Germany
  • Dienemann, Thomas, University Hospital Erlangen, Erlangen, Germany
  • Harazny, Joanna M., University Erlangen-Nueremberg, Erlangen, Germany
  • Schmieder, Roland E., University Hospital Erlangen, Erlangen, Germany
Background

Spectral-domain optical coherence tomography (SD-OCT) represents a reliable tool for retinal layer volume measurement. The aim of this study is to evaluate retinal changes indicating neurodegenerative processes in patients with chronic kidney disease (CKD) undergoing hemodialysis (HD) compared to healthy controls.

Methods

In a prospective observational single center study, we included a total of 70 subjects–32 CKD patients undergoing HD and 38 healthy controls. Circular scans of the optic disc area to determine retinal nerve fiber layer (RNFL) thickness were obtained by SD-OCT and macular retinal layer volumes of both eyes including total retinal volume but also each layer were evaluated.

Results

The group of CKD patients (11 females, 21 males, aged 60.3±15 years) was compared to healthy controls (28 females, 10 males, aged 57.9±10 years). The age- and gender-adjusted temporal superior RNFL sector of the right eye was significantly thinner in HD patients as were several retinal layer volumes such as total retinal volume, ganglion cell layer (GCL), ganglion cell layer + inner plexiform layer (GCL-IPL) and inner retinal layer volume (IRL, comprising RNFL, GCL and IPL) of the right eye and IPL volume of both eyes. To eliminate additive effects of HD and diabetes, we performed a subgroup analysis excluding patients with diabetes mellitus (n=25). The temporal superior RNFL sector was still significantly thinner than in the control group (p=0.021) as were GCL (p=0.014) and GCL-IPL volume of the right eye (p=0.024).

Conclusion

In patients undergoing HD, we observed a decrease in temporal RNFL thickness and retinal layer volumes indicating neurodegenerative retinal alterations in patients with CKD. Thereby, SD-OCT represents a valuable high-resolution imaging technique to explore retinal neurodegenerative changes.

RNFL thickness and retinal volumes
SD-OCT scanHemodialysis (n=32)Healthy controls (n=38)age-/gender-adjusted p value
Temporal superior right sector of the circular RNFL scan [µm]122.58±26.73138.53±20.350.016
Total retinal volume right [mm^3]8.22±0.458.51±0.410.037
GCL volume right [mm^3]0.96±0.101.05±0.080.003
IPL volume right/left [mm^3]0.83±0.08/0.82±0.070.88±0.07/0.88±0.070.017/0.044
IRL volume right [mm^3]6.00±0.436.27±0.380.042
GCL-IPL volume right [mm^3]1.79±0.671.93±0.150.005