Faculty of Medicine, Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical Center, Cheras, Kuala Lumpur, Malaysia.
Department of Ophthalmology, Hospital Tengku Ampuan Afzan, Ministry of Health, Kuantan, Pahang, Malaysia.
PLoS One. 2022 Apr 6;17(4):e0266607. doi: 10.1371/journal.pone.0266607. eCollection 2022.
This study aimed to compare the peripapillary retinal nerve fiber layer (pRNFL) thickness and macular thickness (MT) between patients with non-diabetic chronic kidney disease (NDCKD) and controls, as well as between different stages of NDCKD. We also evaluated the correlation between pRNFL thickness and MT with duration of NDCKD.
This was a comparative cross-sectional study. Subjects were divided into NDCKD and control groups. Both pRNFL thickness and MT, including center subfield thickness (CST), average MT as well as average ganglion cell-inner plexiform layer (GC-IPL) were measured using spectral-domain optical coherence tomography. One-way ANCOVA test was used to compare the differences in pRNFL and MT between NDCKD and controls, as well as between the different stages of NDCKD. Spearman rank-order correlation coefficients were employed to determine the effects of NDCKD duration on pRNFL thickness and MT.
A total of 132 subjects were recruited, 66 with NDCKD and 66 controls. There was a statistically significant difference in superior (110.74 ± 23.35 vs 117.36 ± 16.17 μm, p = 0.022), nasal (65.97 ± 12.90 vs 69.35 ± 10.17 μm, p = 0.006), inferior quadrant (117.44 ± 23.98 vs 126.15 ± 14.75 μm, p = 0.006), average pRNFL (90.36 ± 14.93 vs 95.42 ± 9.87 μm, p = 0.005), CST (231.89 ± 26.72 vs 243.30 ± 21.05 μm, p = 0.006), average MT (268.88 ± 20.21 vs 274.92 ± 12.79 μm, p = 0.020) and average GC-IPL (75.48 ± 12.44 vs 81.56 ± 6.48, p = 0.001) values between the NDCKD group and controls. The superior quadrant (p = 0.007), nasal quadrant (p = 0.030), inferior quadrant (p = 0.047), average pRNFL (p = 0.006), average MT (p = 0.001) and average GC-IPL (p = 0.001) differed significantly between different stages of NDCKD. There was no correlation between pRNFL thickness and MT with duration of NDCKD.
CST, average MT, average GC-IPL thickness, average pRNFL and all quadrants of pRNFL except the temporal quadrant were significantly thinner in NDCKD patients compared to controls. These changes were associated with the severity of CKD, but not its duration.
本研究旨在比较非糖尿病慢性肾脏病（NDCKD）患者与对照组之间以及不同 NDCKD 阶段之间的视盘周围视网膜神经纤维层（pRNFL）厚度和黄斑厚度（MT）。我们还评估了 pRNFL 厚度和 MT 与 NDCKD 持续时间之间的相关性。
这是一项横断面比较研究。受试者分为 NDCKD 组和对照组。使用谱域光学相干断层扫描测量 pRNFL 厚度和 MT，包括中心凹区厚度（CST）、平均 MT 以及平均节细胞内丛状层（GC-IPL）。采用单因素方差分析（ANCOVA）检验比较 NDCKD 组和对照组之间以及不同 NDCKD 阶段之间的 pRNFL 和 MT 差异。采用 Spearman 秩相关系数分析 NDCKD 持续时间对 pRNFL 厚度和 MT 的影响。
共纳入 132 名受试者，其中 66 名为 NDCKD 患者，66 名为对照组。NDCKD 组患者的上象限（110.74±23.35 比 117.36±16.17μm，p=0.022）、鼻侧象限（65.97±12.90 比 69.35±10.17μm，p=0.006）、下象限（117.44±23.98 比 126.15±14.75μm，p=0.006）、平均 pRNFL（90.36±14.93 比 95.42±9.87μm，p=0.005）、CST（231.89±26.72 比 243.30±21.05μm，p=0.006）、平均 MT（268.88±20.21 比 274.92±12.79μm，p=0.020）和平均 GC-IPL（75.48±12.44 比 81.56±6.48μm，p=0.001）值均显著低于对照组。不同 NDCKD 阶段之间上象限（p=0.007）、鼻侧象限（p=0.030）、下象限（p=0.047）、平均 pRNFL（p=0.006）、平均 MT（p=0.001）和平均 GC-IPL（p=0.001）也存在显著差异。pRNFL 厚度和 MT 与 NDCKD 持续时间之间无相关性。
与对照组相比，NDCKD 患者的 CST、平均 MT、平均 GC-IPL 厚度、平均 pRNFL 以及除颞侧象限外的所有 pRNFL 象限均显著变薄。这些变化与 CKD 的严重程度有关，而与持续时间无关。
