Liu Xiao-Hong, Huang Qi-Fang, Chen Yi-Lin, Wang Xin-Yu, Zhong Yi-Sheng, Wang Ji-Guang
Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Department of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Eye (Lond). 2025 Mar;39(4):734-740. doi: 10.1038/s41433-024-03482-7. Epub 2024 Nov 16.
The aim of this study was to investigate the association of macular microcirculation with renal function and the feasibility of using macular microcirculatory parameters to monitor renal function in Chinese non-diabetic patients with hypertension.
This case-control study included 62 non-diabetic patients with hypertension, including 31 with renal dysfunction (estimated glomerular filtration rate [eGFR] <90 mL/min/1.73 m) and 31 with normal renal function (eGFR ≥90 mL/min/1.73 m). Age, sex and clinic blood pressure were matched between groups. Macular microcirculatory parameters of 124 eyes of the 62 patients were evaluated by optical coherence tomography (OCT) and OCT angiography (OCTA).
In comparison with the patients with normal renal function, patients with renal dysfunction had lower macular superficial parafovea vessel density (18.6 vs. 19.4%, P = 0.029), macular cube average thickness (273.0 vs. 280.2 µm, P = 0.003), and average ganglion cell layer and inner plexiform layer (GCL-IPL) thickness (79.5 vs. 82.8 µm, P = 0.006), but similar macular central fovea vessel density and central fovea thickness (P ≥ 0.54). After adjustment for confounders, eGFR was significantly associated with macular superficial parafovea vessel density, cube average thickness and GCL-IPL thickness (P < 0.02). In detecting renal dysfunction, areas under the curve were 0.61, 0.66 and 0.65 for macular superficial parafovea vessel density, cube average thickness and GCL-IPL thickness.
In non-diabetic patients with hypertension, macular superficial parafovea vessel density, cube average thickness and GCL-IPL thickness were significantly worse in patients with renal dysfunction than those with normal renal function. Using macular parameters to monitor renal function is feasible.
本研究旨在探讨黄斑微循环与肾功能之间的关联，以及在中国非糖尿病高血压患者中使用黄斑微循环参数监测肾功能的可行性。
本病例对照研究纳入了62例非糖尿病高血压患者，其中31例肾功能不全（估计肾小球滤过率[eGFR]<90 mL/min/1.73 m²），31例肾功能正常（eGFR≥90 mL/min/1.73 m²）。两组间年龄、性别和临床血压相匹配。通过光学相干断层扫描（OCT）和OCT血管造影（OCTA）评估了62例患者124只眼的黄斑微循环参数。
与肾功能正常的患者相比，肾功能不全的患者黄斑浅部中心凹旁血管密度较低（18.6%对19.4%，P=0.029），黄斑立方体平均厚度较薄（273.0对280.2 µm，P=0.003），神经节细胞层和内丛状层（GCL-IPL）平均厚度较薄（79.5对82.8 µm，P=0.006），但黄斑中心凹血管密度和中心凹厚度相似（P≥0.54）。在调整混杂因素后，eGFR与黄斑浅部中心凹旁血管密度、立方体平均厚度和GCL-IPL厚度显著相关（P<0.02）。在检测肾功能不全时，黄斑浅部中心凹旁血管密度、立方体平均厚度和GCL-IPL厚度的曲线下面积分别为0.61、0.66和0.65。
在非糖尿病高血压患者中，肾功能不全患者的黄斑浅部中心凹旁血管密度、立方体平均厚度和GCL-IPL厚度明显低于肾功能正常者。使用黄斑参数监测肾功能是可行的。
