A cross-sectional study to evaluate ocular manifestations in chronic kidney disease patients in a tertiary care centre

Abstract

Chronic kidney disease (CKD) constitutes a major healthcare issue due to defective microcirculation secondary to systemic hypertension and diabetes mellitus. Hence, the aim is to find the prevalence of ocular pathology, risk factors and its association with the level of kidney function in patients with CKD undergoing haemodialysis. This prospective, cross-sectional study included 105 CKD patients referred to Ophthalmology Department in a tertiary care centre from November 2021 to April 2023. They were evaluated for demographic data, history of systemic comorbidities, visual acuity and ocular pathologies. This was correlated with the stages of CKD which is defined as the presence of glomerular filtration rate (GFR) < 60 mL/min/1.73 m2 and/or proteinuria. Chi-square test or Fischer’s exact test was used as test of significance for qualitative data and Independent t test was used as test of significance to identify the mean difference between two quantitative variables. ANOVA was used as test of significance to identify the mean difference between more than two quantitative variables. Out of 105 [74 (70.5%) male and 31(29.5%) females] CKD patients with mean age 58.43±13.05, ocular pathology was noted in 63 (60%) with hypertensive retinopathy in 47 (44.76%), diabetic retinopathy in 38 (36.19%), mixed retinopathy in 24 (22.85%), cataract in 24 (22.85%), glaucomatous changes in 5 (4.76%), ARMD in 4 (3.8%) and retinal vein occlusion in 3 (2.85%). The mean platelet volume also showed positive correlation with worsening stages of CKD (P-0.015), Hypertensive and diabetic retinopathy (P<0.001). Higher prevalence of ocular pathology 63 (60%) was observed in this study, re-emphasising that ocular screening is mandatory in all chronic kidney disease patients for early detection and initiation of prompt treatment to prevent ocular morbidity.