Associations between retinal microvasculature/microstructure and renal function in type 2 diabetes patients with early chronic kidney disease

Diabetes Res Clin Pract. 2020 Oct:168:108373. doi: 10.1016/j.diabres.2020.108373. Epub 2020 Aug 20.

Abstract

Aims: To explore the associations between the microvascular/microstructural changes in the retina measured by optical coherence tomography angiography (OCTA) and renal function in type 2 diabetes patients with early chronic kidney disease (CKD).

Methods: This cross-sectional study, including 150 type 2 diabetes patients, was conducted from July 2017 to January 2019. We obtained retinal vessel density (VD) and retinal thickness using OCTA. The correlations between OCTA-derived parameters and CKD-related systemic data were assessed by multiple regression analyses.

Results: We found a significant decrease of VD in patients with CKD. Multiple regression analyses showed that: a) decreased eGFR (estimated glomerular filtration rate) was significantly correlated with decreased VD of superficial vascular complex (SVC) in macular area; b) increased UACR (urine albumin to creatinine ratio) was significantly associated with increased macular thickness; c) decreased HGB/HCT (Hemoglobin or Hematocrit) was significantly correlated with both decreased VD of SVC and increased retinal thickness in macular area.

Conclusions: Decrease in the microcirculation of the retina and thickening of the macula associated with impaired renal function in type 2 diabetes. Our finding encourages the application of OCTA-derived metrics in diabetic eyes to monitor the progression of CKD.

Keywords: Diabetes complications; Diabetes mellitus; Diabetic angiopathies; Diabetic nephropathies; Diabetic retinopathy; Diagnostic imaging; Type 2.

MeSH terms

  • Cross-Sectional Studies
  • Diabetes Complications / complications*
  • Diabetic Retinopathy / physiopathology*
  • Female
  • Humans
  • Male
  • Microcirculation
  • Microvessels
  • Middle Aged
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / etiology*
  • Retina / physiopathology*
  • Retinal Vessels / physiopathology*
  • Retrospective Studies