Wan Qian-Qian, Zhou Jin-Qiong, Fang Li-Jian, Wang Ya-Xing, Wang Ye-Nan, Wang Qian, Yan Yan-Ni, Yang Xuan, Wu Shou-Ling, Chen Shuo-Hua, Jonas Jost B, Wei Wen-Bin
Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Department of Ophthalmology, the Second Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China.
Int J Ophthalmol. 2024 Sep 18;17(9):1696-1706. doi: 10.18240/ijo.2024.09.18. eCollection 2024.
To investigate whether retinal nerve fiber layer defects (RNFLDs) is a potential risk factor for chronic kidney disease (CKD) in Chinese adults.
The Kailuan Eye Study was a population-based study that included 14 440 participants. All participants underwent detailed assessments, RNFLDs were diagnosed using color fundus photographs.
Overall, 12 507 participants [8533 males (68.23%)] had complete systemic examination data and at least one evaluable fundus photograph. RNFLDs were found in 621 participants [5.0%; 95% confidence interval (CI): 4.6%-5.34%], and 70 cases of multiple RNFLDs were found (11.27%). After adjusting multiple factors, RNFLDs was significantly associated with CKD severity, the ORs of CKD stage 3, stage 4 and stage 5 were 1.698, 4.167, and 9.512, respectively. Multiple RNFLDs were also associated with CKD severity after adjusting multiple factors, the ORs of CKD stage 3 and stage 5 were 4.465 and 11.833 respectively. Furthermore, 2294 participants had CKD (18.34%, 95%CI: 17.68%-18.99%). After adjusting for other factors, CKD presence was significantly correlated with the presence of RNFLDs.
The strongest risk factors for RNFLDs are CKD and hypertension. Conversely, RNFLDs can be an ocular feature in patients with CKD. Fundoscopy can help detect systemic diseases, and assessment for RNFLDs should be considered in CKD patients.
探讨视网膜神经纤维层缺损（RNFLDs）是否为中国成年人慢性肾脏病（CKD）的潜在危险因素。
开滦眼病研究是一项基于人群的研究，纳入了14440名参与者。所有参与者均接受了详细评估，使用彩色眼底照片诊断RNFLDs。
总体而言，12507名参与者[8533名男性（68.23%）]拥有完整的全身检查数据和至少一张可评估的眼底照片。621名参与者（5.0%；95%置信区间[CI]：4.6%-5.34%）发现有RNFLDs，其中70例为多发性RNFLDs（11.27%）。调整多个因素后，RNFLDs与CKD严重程度显著相关，CKD 3期、4期和5期的比值比（OR）分别为1.698、4.167和9.512。调整多个因素后，多发性RNFLDs也与CKD严重程度相关，CKD 3期和5期的OR分别为4.465和11.833。此外，2294名参与者患有CKD（18.34%，95%CI：17.68%-18.99%）。调整其他因素后，CKD的存在与RNFLDs的存在显著相关。
RNFLDs的最强危险因素是CKD和高血压。相反，RNFLDs可能是CKD患者的眼部特征。眼底镜检查有助于发现全身性疾病，CKD患者应考虑评估RNFLDs。
