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Quantitative analysis of retinal and choroidal microvascular parameters using optical coherence tomography angiography in children with nephrotic syndrome: a pilot study

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To study the retinal and choroidal microvascular parameters in children with nephrotic syndrome (NS).

Methods

This is a cross-sectional study. Optical coherence tomography angiography was used to evaluate the changes of retinal and choroidal microvessels in patients with NS. Thirty NS children and 20 normal controls were included in this study. The macular vessel density (VD) of the superficial capillary plexus (SCP), deep capillary plexus (DCP), choroid capillary plexus (CCP), and foveal avascular zone (FAZ) area of the SCP and DCP was quantitatively calculated. Clinical data including serum protein, blood lipid, uric acid, urea, serum creatinine, urinary protein concentration, urinary creatinine, 24-h urine volume, 24-h urinary total protein, 24-h creatinine clearance rate, and urinary albumin to creatinine ratio were collected.

Results

The VDs of the DCP and CCP in children with NS were significantly lower than those in controls (59.35 ± 2.45 vs. 61.15 ± 1.53, p = 0.002, 66.34 ± 1.43 vs. 67.16 ± 1.23, p = 0.042, respectively). The VD of the SCP in children with NS had a tendency to decrease compared with that in controls, but there were no significant differences. There were also no significant differences in FAZ area between the two groups. The VD of the SCP was positively correlated with serum total protein (ρ = 0.446, p = 0.014), serum albumin (ρ = 0.431, p = 0.017), and 24-h urine volume (ρ = 0.389, p = 0.034) but negatively correlated with triglyceride (ρ = − 0.450, p = 0.013), low-density lipoprotein cholesterol (ρ = −0.432, p = 0.017), urinary protein concentration (ρ = − 0.606, p < 0.001), and 24-h urinary total protein (ρ = − 0.517, p = 0.004). The VDs of the SCP, DCP, and CCP were negatively correlated with the urinary albumin to creatinine ratio (ρ = − 0.473, p = 0.008, ρ = − 0.438, p = 0.015, ρ = −0.467, p = 0.009, respectively).

Conclusions

Retinal and choroidal VDs were decreased in children with NS and paralleled the severity of kidney disease. Optical coherence tomography angiography can be used as a noninvasive method for evaluating renal injury in patients with NS.

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Abbreviations

CT:

choroidal thickness

CCP:

choroid capillary plexus

DCP:

deep capillary plexus

FAZ:

foveal avascular zone

ILM:

inner limiting membrane

IPL:

inner plexiform layer

NS:

nephrotic syndrome

OCTA:

optical coherence tomography angiography

RAS:

renin angiotensin system

RPE:

retinal pigment epithelium

RT:

retinal thickness

SCP:

superficial capillary plexus

UACR:

urinary albumin to creatinine ratio

VD:

vessel density.

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Acknowledgments

Thanks are due to Xuan Zhao, Northeast Agricultural University, for her support in data processing.

Funding

This study was funded by the National Natural Science Foundation of China (grant number 81670841), and Beijing Natural Science Foundation (grant number 7172218). The funding body had no influence on the design, collection, analysis, or interpretation of the data or on the writing of the manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China

    Wenbo Zhang, Lei Kang, Yadi Zhang, Liang Zhao, Ruilin Zhu, Xiaopeng Gu, Hailong Wu, Xiaosha Wang & Liu Yang

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  1. Wenbo Zhang
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  2. Lei Kang
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  3. Yadi Zhang
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  4. Liang Zhao
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  5. Ruilin Zhu
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  6. Xiaopeng Gu
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  7. Hailong Wu
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  8. Xiaosha Wang
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  9. Liu Yang
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Contributions

Liu Yang and Wenbo Zhang designed the study. Wenbo Zhang, Lei Kang, Xiaopeng Gu, Yadi Zhang, Ruilin Zhu, Liang Zhao, Xiaosha Wang, and Hailong Wu were responsible for the data collection. Wenbo Zhang, Lei Kang, and Yadi Zhang contributed to the data analysis. Wenbo Zhang was mainly responsible for writing the manuscript. Liu Yang revised and edited the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Liu Yang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all the parents/legal guardians of the participants included in the study.

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Cite this article

Zhang, W., Kang, L., Zhang, Y. et al. Quantitative analysis of retinal and choroidal microvascular parameters using optical coherence tomography angiography in children with nephrotic syndrome: a pilot study. Graefes Arch Clin Exp Ophthalmol 258, 289–296 (2020). https://doi.org/10.1007/s00417-019-04561-2

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  • DOI: https://doi.org/10.1007/s00417-019-04561-2

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