Purpose: To assess neurodegeneration and chorioretinal thickness in subjects with and without chronic kidney disease (CKD).
Methods: PubMed, Web of Science, Scopus, and Embase were searched using proper keywords for articles published in the English language from their inception until January 2024. Publications were included if they reported optical coherence tomography measurements of retinal or choroidal layers in patients with CKD compared with healthy or non-CKD controls. We used a random-effects model to calculate pooled standardized mean difference (SMD) estimates and 95% confidence intervals (CIs).
Results: Twelve studies, with 29,340 patients, were included in quantitative synthesis. In comparison to controls, patients with CKD had a significantly lower value for average retinal thickness (SMD [CI], -0.35 [-0.58 to -0.12], P = 0.028), choroidal thickness (SMD [CI], -1.84 [-4.17 to 0.49], P = 0.122), macular ganglion cell-inner plexiform layer (SMD [CI], -0.58 [-0.78 to -0.38]], P < 0.001), and peripapillary retinal nerve fiber layer thickness (SMD [CI], -0.32 [-0.44 to -0.20], P < 0.001). Significant retinal nerve fiber layer thinning was observed in both diabetic CKD excluded and not excluded subgroups.
Conclusion: Compared with controls, the eyes of patients with CKD have significantly thinner retina, ganglion cell-inner plexiform layer, and retinal nerve fiber layer.
Keywords: chorioretinal thickness; chronic kidney disease; diabetes mellitus; imaging; meta-analysis; optical coherence tomography; retina; retinal nerve fiber layer.