Evaluation of Visual Acuity, Macular Thickness, and Level of Proteinuria in Children with Nephrotic Syndrome
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Purpose: Macular edema, serous retinal detachment, and retinal pigment epithelial detachment have been reported in patientswith nephrotic syndrome. However, there is limited data about macular thickness in children with nephrotic syndrome. The aim of this study was to compare the mean macular thickness in children with nephrotic syndrome and in a control groupand to correlate it with visual acuity and level of proteinuria. Methods: The comparative cross-sectional study included 66 children aged 6 to 17 years with nephrotic syndrome andhealthy control seen in two tertiary centers in Malaysia. We recorded demographic data, as well as visual acuity, level of proteinuria,and the mean macular thicknesses in both groups. The mean macular thickness was measured using Stratus opticalcoherence tomography according to nine areas of the Early Treatment Diabetic Retinopathy Study map. Results: The mean foveal thickness was 238.15 ± 22.98 μm for children with nephrotic syndrome and 237.01 ± 22.60 μm forthe control group. There was no significant difference in the mean macular thickness between the groups (p = 0.843). A significantcorrelation with visual acuity was observed in the superior outer macula (r = –0.41, p = 0.019), the nasal outer macula(r = –0.41, p = 0.019), and the inferior outer macula (r = –0.40, p = 0.021). There was no significant correlation between themean macular thickness and level of proteinuria (p = 0.338), although those with higher levels of proteinuria demonstrated atrend towards increased macular thickness. Conclusions: The mean macular thickness in children with nephrotic syndrome was similar to that of healthy children. A significantcorrelation between the mean thickness of the outer macular layer and the presenting visual acuity was observed. There was no correlation between the mean macular thickness and the level of proteinuria.
Abstract
Purpose: Macular edema, serous retinal detachment, and retinal pigment epithelial detachment have been reported in patientswith nephrotic syndrome. However, there is limited data about macular thickness in children with nephrotic syndrome. The aim of this study was to compare the mean macular thickness in children with nephrotic syndrome and in a control groupand to correlate it with visual acuity and level of proteinuria. Methods: The comparative cross-sectional study included 66 children aged 6 to 17 years with nephrotic syndrome andhealthy control seen in two tertiary centers in Malaysia. We recorded demographic data, as well as visual acuity, level of proteinuria,and the mean macular thicknesses in both groups. The mean macular thickness was measured using Stratus opticalcoherence tomography according to nine areas of the Early Treatment Diabetic Retinopathy Study map. Results: The mean foveal thickness was 238.15 ± 22.98 μm for children with nephrotic syndrome and 237.01 ± 22.60 μm forthe control group. There was no significant difference in the mean macular thickness between the groups (p = 0.843). A significantcorrelation with visual acuity was observed in the superior outer macula (r = –0.41, p = 0.019), the nasal outer macula(r = –0.41, p = 0.019), and the inferior outer macula (r = –0.40, p = 0.021). There was no significant correlation between themean macular thickness and level of proteinuria (p = 0.338), although those with higher levels of proteinuria demonstrated atrend towards increased macular thickness. Conclusions: The mean macular thickness in children with nephrotic syndrome was similar to that of healthy children. A significantcorrelation between the mean thickness of the outer macular layer and the presenting visual acuity was observed. There was no correlation between the mean macular thickness and the level of proteinuria.
참고문헌 (20)
- Ismail HI, "Paediatric protocols for Malaysian hospitals" (2019), Malaysian Paediatric Association
- Bhimma R, "Steroid-resistant nephrotic syndrome : the influence of race on cyclophosphamide sensitivity", Pediatr Nephrol, 21, pp.1847~1853 (2006)
- Hogg R J, "Evaluation and management of proteinuria and nephrotic syndrome in children: recommendations from a pediatric nephrology panel established at the National Kidney Foundation conference on proteinuria, albuminuria, risk, assessment, detection, and elimination (PARADE)", Pediatrics, 105, pp.1242~1249 (2000)
- Hacıhamdioglu DO, "Long-term results of children diagnosed with idiopathic nephrotic syndrome : single center experience", Turk Pediatri Ars, 50, pp.37~44 (2015)
- Downie ML, "Nephrotic syndrome in infants and children : pathophysiology and management", Paediatr Int Child Health, 37, pp.248~258 (2017)
- Hayasaka Y, "Ocular findings in Japanese children with nephrotic syndrome receiving prolonged corticosteroid therapy", Ophthalmologica, 220, pp.181~185 (2006)
- Agrawal V, "Study on steroid induced ocular findings in children with nephrotic syndrome", J Clin Diagn Res, 11, pp.SC05~6 (2017)
- De Benedetto U, "Retinal involvement in nephrotic syndrome secondary to minimal change disease", Eur J Ophthalmol, 22, pp.843~845 (2012)
- Bilge AD, "Bilateral serous macular detachment in a patient with nephrotic syndrome", Retin Cases Brief Rep, 12, pp.260~262 (2018)
- Izzedine H, "Bilateral serous retinal detachment as a presenting sign of nephrotic syndrome", Intern Med, 53, pp.2609~2613 (2014)
- Wong MH, "Exudative detachment as a masquerader in hypoalbuminaemic patients", Clin Kidney J, 7, pp.406~410 (2014)
- Hager A, "Bilateral serous detachment of the neurosensory retina and retinal pigment epithelium with rip of the peripheral pigment epithelium", Ophthalmologe, 103, pp.966~970 (2006)
- Zhang W, "Retinal and choroidal thickness in paediatric patients with hypoalbuminaemia caused by nephrotic syndrome", BMC Ophthalmol, 19, pp.44~ (2019)
- Zhang W, "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, pp.289~296 (2020)
- Ng JS, "Ocular complications of paediatric patients with nephrotic syndrome", Clin Exp Ophthalmol, 29, pp.239~243 (2001)
- Gaur S, "Ocular complications in children with nephrotic syndrome on long term oral steroids", Indian J Pediatr, 81, pp.680~683 (2014)
- Sacconi R, "Emerging therapies in the management of macular edema : a review", F1000Res, 8(F1000 Faculty Rev), pp.1413~ (2019)
- Cunha-Vaz J, "The blood-retinal barrier in the management of retinal disease : EURETINA award lecture", Ophthalmologica, 237, pp.1~10 (2017)
- Mwanza JC, "Macular ganglion cell-inner plexiform layer : automated detection and thickness reproducibility with spectral domain-optical coherence tomography in glaucoma", Invest Ophthalmol Vis Sci, 52, pp.8323~8329 (2011)
- Shin YU, "Optical coherence tomography angiography analysis of changes in the retina and the choroid after haemodialysis", Sci Rep, 8, pp.17184~ (2018)