Affiliation:
1. Sun Yat-Sen University Zhongshan Ophthalmic Center
2. HK PolyU: The Hong Kong Polytechnic University
3. The Royal Victorian Eye and Ear Hospital
Abstract
Abstract
Background
Chronic kidney disease (CKD) is a risk factor for neurodegenerative diseases (NDDs), and ganglion cell-inner plexiform layer (GCIPL) thickness is an early and sensitive biomarker for NDDs, but previous studies have yielded conflicting results.
Objective
To assess the effect of CKD on GCIPL thickness in multi-country cohorts.
Method
This prospective observational study included 23,014 non-NDDs individuals from the UK Biobank, and three years of continuous follow-up data of 2,197 individuals from a Chinese cohort. Three groups were defined by eGFR based on serum creatinine classifying CKD severity as no CKD, Mild-CKD, and moderate-to-severe CKD (MS-CKD). The GCIPL thickness and its decline rate measured using optical coherence tomography.
Results
In the cross-sectional analysis, poorer renal function negatively correlated with GCIPL thickness with the mean decrease of 0.15 µm (95% CI -0.30 to -0.01; p = 0.038) in mild CKD, and 0.83 µm (95% CI -1.34 to -0.32; p = 0.002) in MS-CKD, compared to that of controls without CKD. Longitudinal analysis showed that the GCIPL decreased more rapidly in persons with poorer renal function. After correcting for confounders, the rate of GCIPL decline accelerated significantly as the CKD severity increased, by 0.30 µm/year (95% CI -0.41 to -0.19; p < 0.001) in mild CKD patients and by 0.52 µm/year (95% CI -0.79 − -0.26; p < 0.001) in MS-CKD, compared to controls without CKD. This relationship sustained in individuals with diabetes or hypertension.
Conclusions
Renal impairment accelerated the rate at which GCIPL thickness decreased over time, which hold across ethnicities and persons with varied health statuses.
Publisher
Research Square Platform LLC
Reference25 articles.
1. Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016;GBD 2016 Neurology Collaborators;Lancet Neurol,2019
2. The retina as a window to the brain-from eye research to CNS disorders;London A;Nat Rev Neurol,2013
3. Kashani AH, Asanad S, Chen J, Singer MB, Zhang J, Sharifi M et al. Past, present and future role of retinal imaging in neurodegenerative disease.Prog Retin Eye Res2021:100938.
4. Association of Retinal Neurodegeneration on Optical Coherence Tomography With Dementia: A Population-Based Study;Mutlu U;Jama Neurol,2018
5. Association of Retinal Nerve Fiber Layer Thinning With Current and Future Cognitive Decline: A Study Using Optical Coherence Tomography;Ko F;Jama Neurol,2018