Changes of vessel density and macular perfusion measured by optical coherence tomography angiography in patients with non-diabetic end-stage renal disease undergoing peritoneal dialysis / 中华眼底病杂志

ABSTRACT

Objective:To observe the changes of blood flow density and perfusion density in the macula of non-diabetic peritoneal dialysis (PD) patients, and their correlation with blood pressure, total protein, albumin, prealbumin, serum creatinine, urea, and high-sensitivity C-reactive protein were preliminarily analyzed.Methods:A single-center, cross-sectional, clinical observational study. From January to December 2018, 63 eyes of 63 non-diabetic patients (non-diabetic PD group) and 75 eyes of normal healthy people (the normal control group) who underwent PD treatment at the PD Center of Peking University First Hospital were included in the study. All were monocular into the group. Among the 63 patients in the non-diabetic PD group, 24 were males and 39 were females. The duration of PD was 7 to 185 months, with the average duration of 67.87±48.36 months. There were 75 healthy persons in the normal control group. There was no significant difference in age ( t=-0.558), sex ratio ( χ2=0.492), axial length ( t=-1.197), and BCVA between the two groups ( P>0.05). OCT angiography was used to scan the macular area of 3 mm×3 mm and 6 mm×6 mm in the subject’s right eye. The blood flow density and perfusion density of superficial retinal capillaries in the macular area, as well as the area, circumference, and morphological index of the foveal avascular zone (FAZ) were measured. The blood flow density and perfusion density at different locations in the macular area of the two groups of eyes were compared by independent sample t test. The blood pressure, total protein, albumin, prealbumin, serum creatinine, urea, and high-sensitivity C-reactive protein was performed by Pearson correlation analysis. Results:Compared with the healthy control group, the blood flow density and perfusion density of superficial retinal capillaries in the macular area of the non-diabetic PD group decreased in different scanning ranges with the macular vessel 3×3 center ( t=-2.409), the macular vessel 3×3 macular ( t=-2.423), macular vessel 3×3 intact ( t=-2.759), macular vessel 6×6 intact ( t=-1.882), macular vessel 6×6 outer layer ( t=-2.188), macular perfusion 3×3 center ( t=-1.990), macular perfusion 3×3 complete ( t=-2.719), macular perfusion 6×6 complete ( t=-2.113), and macular perfusion 6×6 outer layer ( t=-2.205). The difference was statistically significant ( P<0.05). The comparison of the macular FAZ area of the two groups of eyes was statistically significant ( t=1.985, P <0.05). Correlation analysis showed that 3×3 macular blood vessels were intact and mean arterial pressure was positively correlated ( r=0.256, P=0.043). The macular blood vessels were 3×3 intact, macular perfusion was 3×3 intact, and macular blood was 6×6 intact, which the pre-white protein was positively correlated with ( r=0.468, 0.362, 0.333; P<0.001, P=0.004, 0.008). The macular vessel 3×3 was intact, the macular perfusion 6×6 was intact, which the hypersensitive C-reactive protein was negatively correlated with ( r=-0.370, -0.287, P=0.005, 0.030). Conclusion:The superficial retinal blood flow density and perfusion density in the macular area of non-diabetic PD patients are lower than those of normal healthy people.