Systematic Review and Meta-Analysis of OCT measurements in patients with chronic kidney disease

Retina. 2024 Dec 27. doi: 10.1097/IAE.0000000000004377. Online ahead of print.

Abstract

Purpose: To assess neurodegeneration and chorioretinal thickness in subjects with and without chronic kidney disease (CKD).

Methods: PubMed, Web of Science, Scopus and Embase were searched using proper keywords for articles published in the English language from their inception until January 2024. Publications were included if they reported optical coherence tomography (OCT) measurements of retinal or choroidal layers in patients with CKD compared to healthy or non-CKD controls. We used a random-effects model to calculate pooled standardized mean difference (SMD) estimates and 95% confidence intervals (CIs).

Results: Twelve studies, with 29,340 patients, were included in quantitative synthesis. In comparison to controls, patients with CKD had a significantly lower value for average retinal thickness (SMD [CI]: -0.35 [-0.58; -0.12], P = 0.028), choroidal thickness (SMD [CI]: -1.84 [-4.17; 0.49], P = 0.122), macular ganglion cell-inner plexiform layer (GC-IPL) (SMD [CI]: -0.58 [-0.78; -0.38]], P < 0.001), and peripapillary retinal nerve fiber layer (RNFL) thickness (SMD [CI]: -0.32 [-0.44; -0.20], P < 0.001). Significant RNFL thinning was observed in both diabetic CKD excluded and not excluded subgroups.

Conclusion: Compared to controls, the eyes of patients with CKD have significantly thinner retina, GC-IPL, and RNFL.