Spectral-Domain Optical Coherence Tomography for Determination of Retinal Thickness in Pediatric Patients with Mild-To-Moderate Chronic Kidney Disease: A Cross-Sectional Study
Spectral-Domain Optical Coherence Tomography for Determination of Retinal Thickness in Pediatric Patients with Mild-To-Moderate Chronic Kidney Disease: A Cross-Sectional Study
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DOI：
10.1080/02713683.2018.1522649
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发表时间：
2019-02-01
影响因子：
2
通讯作者：
Fischer, Dagmar-C.
中科院分区：
文献类型：
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作者：
Prakasam, Ruby K.;Goetze, Aline;Fischer, Dagmar-C.
目的：慢性肾脏疾病(CKD)儿童在成年早期就有患神经系统疾病的危险。视网膜光谱域光学相干层析成像(SD-OCT)特别适用于视网膜内层厚的测定。我们想知道轻到中度慢性肾脏病的儿童患者是否已经出现视网膜变薄。患者和方法：因肾小球疾病、先天性肾和尿路畸形(CAKUT)或溶血性尿毒症综合征(HUS)引起的轻至中度CKD患儿(n=15；14.9+/-2.4岁)(中位数EGFR为95ml/min/1.73m(2)；范围：28-187ml/min/1.73m(2))进行了详细的眼科检查。所有患者的右眼均行三次OCT扫描。在每一次扫描中，视网膜各层被分离，并确定中心凹、中央凹旁和中心凹周围区域的平均厚度。这些结果与我们之前从健康儿童身上获得的结果进行了比较。结果：黄斑旁视网膜全层(ALL)、神经节细胞层(GCL)和内丛状层(IPL)厚度(中位数，范围)分别为339 mm(288~361 mm)和348 mm(320~385 mm)；49.8亩(30.5~56.6亩)与53.5亩(49.5~60.5亩)和41.0亩(29.4~43.7亩)与43.46亩(39.5~46.3亩)；黄斑中心凹和中心凹周围区域的视网膜内厚度测量显示，患者和对照组之间没有统计学上的显著差异。结论：轻至中度CKD患儿的全视网膜中央凹旁区域、GCL和IPL均有明显变化。需要进行前瞻性研究来评估我们研究结果的临床意义。
Objective: Children with chronic kidney diseases (CKD) are at risk for neurological diseases at early adulthood. Spectral-domain optical coherence tomography (SD-OCT) of the retina is especially suitable for determination of intraretinal layer thickness. We wonder whether retinal thinning is already present in pediatric patients with mild-to-moderate CKD. Patients and Methods: Children (n = 15; 14.9 +/- 2.4 years) with mild-to-moderate CKD (median eGFR of 95ml/min/1.73m(2); range: 28-187ml/min/1.73m(2)) due to glomerulopathy, congenital anomalies of kidney and urinary tract (CAKUT), or haemolytic uremic syndrome (HUS) underwent a detailed ophthalmologic examination including high-resolution SD-OCT. Three OCT scans were obtained from the right eyes of all patients. Within each scan, retinal layers were separated and the mean thickness was determined at the foveal, parafoveal, and perifoveal area. The results were compared to those we obtained previously from healthy children. Results: At the parafoveal area, thickness (median, range) of the total retina (ALL), ganglion cell layer (GCL), and inner plexiform layer (IPL) were reduced compared to healthy volunteers (339 mu m, (288-361 mu m) vs. 348 mu m, (320-385 mu m); 49.8 mu m (30.5-56.6 mu m) vs. 53.5 mu m (49.5-60.5 mu m) and 41.0 mu m (29.4-43.7 mu m) vs. 43.46 mu m (39.5-46.3 mu m); each p < 0.05). The intraretinal thickness measurements at the foveal and perifoveal areas revealed no statistically significant differences between patients and controls. Conclusion: Distinct changes within the parafoveal area of the total retina, GCL, and IPL are present in children with mild-to-moderate CKD. Prospective studies are required to assess the clinical significance of our findings.