Association of the occurrence of reticular macular diseases with chronic kidney disease based on estimated glomerular filtration rate

Objective

To analyze the relationship between reticular macular disease (RMD) and chronic kidney disease (CKD) by estimated glomerular filtration rate (eGFR).

Methods

A cross-sectional study was conducted.Thirty-six consecutive patients (71 eyes) with subretinal drusenoid deposits in at least one eye in optical coherence tomography (OCT) images were enrolled as the RMD group, and 29 consecutive patients (50 eyes) with age-related macular degeneration (AMD) in at least one eye were identified as the non-RMD group at the First Affiliated Hospital of Guangzhou Medical University from February to September 2019.In the same period, 32 healthy volunteers (64 eyes) without eye disease were included as the healthy control group.Serum was collected to calculate the estimated creatinine clearance (eCcr) and the eGFR.The choroidal thickness of macular fovea and the flow density of choroidal capillary layer were measured by OCT.The related factors of RMD and the correlation between CKD and RMD were analyzed by multiple logistic regression analysis.The relationship between eGFR and choroidal capillary blood flow density and foveal choroidal thickness in RMD patients was analyzed by Pearson linear correlation analysis.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the First Affiliated Hospital of Guangzhou Medical University (No.2022-50)

Results

The eGFR value of the RMD group was (66.40±27.58)ml/(min·1.73 m²), which was significantly lower than (84.40±20.91)ml/(min·1.73 m²) of the non-RMD group and (87.64±22.32)ml/(min·1.73 m²) of the healthy control group (both at P<0.01). eGFR was significantly correlated with the occurrence of RMD ([odds ratio, OR]=0.973, 95%[confidence interval, CI]: 0.954-0.992, P=0.005). Subgroup analysis showed that this correlation was significant in the CKD stage (eGFR<60 ml/[min·1.73 m²]) (OR=6.482, 95%CI: 1.543-27.236, P=0.011). The choroidal thickness of the macular fovea in the RMD group was significantly lower than that of the non-RMD grup and healthy control group (both at P<0.01). In the RMD group, no significant correlation was found between the choroidal thickness of the macular fovea and eGFR (r=0.138, P>0.05), and the flow density of choroidal capillary layer was moderately positively correlated with eGFR (r=0.457, P<0.05).

Conclusions

There is a correlation between the occurrence of CKD and RMD, which may be due to the confounding effect of the systemic microcirculation disorder.

Macular degeneration, age-related; Glomerular filtration rate; Chronic kidney disease; Reticular macular disease