PT  - JOURNAL ARTICLE
AU  - Wei Wang
AU  - Miao He
AU  - Xia Gong
AU  - Lanhua Wang
AU  - Jie Meng
AU  - Yuting Li
AU  - Kun Xiong
AU  - Wangting Li
AU  - Wenyong Huang
TI  - Association of renal function with retinal vessel density in patients with type 2 diabetes by using swept-source optical coherence tomographic angiography
AID  - 10.1136/bjophthalmol-2019-315450
DP  - 2020 Dec 01
TA  - British Journal of Ophthalmology
PG  - 1768--1773
VI  - 104
IP  - 12
4099  - http://bjo.bmj.com/content/104/12/1768.short
4100  - http://bjo.bmj.com/content/104/12/1768.full
SO  - Br J Ophthalmol2020 Dec 01; 104
AB  - Aims To investigate the relationship between retinal vessel density and renal function in patients with diabetes mellitus (DM) using non-invasive optical coherence tomographic angiography (OCTA).Methods This prospective cross-sectional study recruited ocular-treatment-naïve patients with DM registered in the community of Guangzhou, China. The retinal vessel density of the superficial capillary plexus in the macula was obtained by using swept-source OCTA imaging. The Xiangya equation was used to calculate the estimated glomerular filtrate rate (eGFR). Participants were divided into the following groups by eGFR: no chronic kidney disease (non-CKD), mild CKD and moderate-to-severe CKD (MS-CKD).Results A total of 874 patients with DM (874 eyes), with a mean age of 64.8±7.1 years, were included in the final analysis. The vessel density was significantly lower in patients with CKD than in non-CKD patients in a dose–response pattern, with a parafoveal vessel density of 49.1%±2.1% in non-CKD, 48.4%±1.9% in mild CKD and 47.2%±1.7% in MS-CKD (p<0.001). The sparser retinal capillaries were related to lower eGFR (β=0.037; 95% CI 0.025 to 0.049; p<0.001) and higher microalbuminuria (β = –0.023; 95% CI –0.039 to –0.008; p=0.002). The eGRF was independently associated with parafoveal vessel density (β=0.029; 95% CI 0.016 to 0.042; p<0.001), even after adjusting for other factors.Conclusion Retinal vessel density decreased with renal function impairment, underlining the potential value of OCTA to detect early microvascular damage in the kidney in patients with diabetes.