Retinal nerve fiber layer defects and chronic kidney disease:the Kailuan Eye Study

AIM:To investigate whether retinal nerve fiber layer defects(RNFLDs)is a potential risk factor for chronic kidney disease(CKD)in Chinese adults.METHODS:The Kailuan Eye Study was a populationbased study that included 14440 participants.All participants underwent detailed assessments,RNFLDs were diagnosed using color fundus photographs.RESULTS:Overall,12507 participants[8533 males(68.23%)]had complete systemic examination data and at least one evaluable fundus photograph.RNFLDs were found in 621 participants[5.0%;95%confidence interval(CI):4.6%-5.34%],and 70 cases of multiple RNFLDs were found(11.27%).After adjusting multiple factors,RNFLDs was significantly associated with CKD severity,the ORs of CKD stage 3,stage 4 and stage 5 were 1.698,4.167,and 9.512,respectively.Multiple RNFLDs were also associated with CKD severity after adjusting multiple factors,the ORs of CKD stage 3 and stage 5 were 4.465 and 11.833 respectively.Furthermore,2294 participants had CKD(18.34%,95%CI:17.68%-18.99%).After adjusting for other factors,CKD presence was significantly correlated with the presence of RNFLDs.CONCLUSION:The strongest risk factors for RNFLDs are CKD and hypertension.Conversely,RNFLDs can be an ocular feature in patients with CKD.Fundoscopy can help detect systemic diseases,and assessment for RNFLDs should be considered in CKD patients.

Effects of vitrectomy combined with internal limiting membrane peeling in patients with diabetic macular edema

BACKGROUND Diabetic macular edema(DME),a chronic microvascular complication of diabetes,is a leading cause of visual impairment and blindness.Pars plana vitrectomy(PPV)can restore the normal macular structure and reduce macular edema,whereas internal limiting membrane(ILM)peeling is used to treat tractional macular diseases.Despite the advantages,there is limited research on the combined effects of PPV with ILM peeling.AIM To observe the effects of PPV combined with ILM peeling on postoperative central macular thickness(CMT),best-corrected visual acuity(BCVA),cystoid macular edema(CME)volume,and complications in patients with DME.METHODS Eighty-one patients(92 eyes)diagnosed with DME at the Beijing Shanqu Liangxiang Hospital between January and December 2022 were randomly divided to undergo PPV alone(control group:41 patients,47 eyes)or PPV+ILM peeling(stripping group:40 patients,45 eyes);a single surgeon performed all surgeries.The two groups were compared preoperatively and 1 and 3 months postoperatively.RESULTS Preoperatively,both groups had comparable values of CMT,BCVA,and CME volume(P>0.05).After surgery(both 1 and 3 months),both groups showed significant reductions in CMT,BCVA,and CME volume compared to preoperative levels,with the stripping group showing more significant reductions compared to the control group(P<0.05).Further repeated-measures ANOVA analysis for within-group differences revealed significant effects of group and time,and interaction effects for CMT,BCVA,and CME volume(P<0.05).There were no significant differences in the incidence of complications between the groups(retinal detachment:control=2,stripping=1;endophthalmitis:Control=4,stripping=1;no cases of secondary glaucoma or macular holes;χ^(2)=0.296,P=0.587).CONCLUSION PPV with ILM peeling can significantly improve the visual acuity of patients with DME,reduce CMT,and improve CME with fewer complications.

Analysis of risk and protective factors associated with retinal nerve fiber layer defect in a Chinese adult population

AIM:To investigate the risk and protective factors associated with the retinal nerve fiber layer defect(RNFLD)in a Chinese adult population.METHODS:This study was a cross-sectional populationbased investigation including employees and retirees of a coal mining company in Kailuan City,Hebei Province.All the study participants underwent a comprehensive systemic and ophthalmic examination.RNFLD was diagnosed on fundus photographs.Binary logistic regression was used to investigate the risk and protective factors associated with the RNFLD.RESULTS:The community-based study included 14440 participants.There were 10473 participants in our study,including 7120 males(68.0%)and 3353 females(32.0%).The age range was 45-108y,averaging 59.56±8.66y.Totally 568 participants had RNFLD and the prevalence rate was 5.42%.A higher prevalence of RNFLD was associated with older age[P<0.001,odds ratio(OR):1.032;95%confidence interval(CI):1.018-1.046],longer axial length(P=0.010,OR:1.190;95%CI:1.042-1.359),hypertension(P=0.007,OR:0.639;95%CI:0.460-0.887),and diabetes mellitus(P=0.019,OR:0.684;95%CI:0.499-0.939).The protective factors of RNFLD were visual acuity(P=0.038,OR:0.617;95%CI:0.391-0.975),and central anterior chamber depth(P=0.046,OR:0.595;95%CI:0.358-0.990).CONCLUSION:In our cross-sectional community-based study,with an age range of 45-108y,RNFLD is associated with older age,longer axial length,hypertension,and diabetes mellitus.The protective factors of RNFLD are visual acuity and central anterior chamber depth.These can help to predict and evaluate RNFLD related diseases and identify high-risk populations early.