A HOSPITAL-BASED STUDY OF FUNDUS CHANGES IN EYES OF CHRONIC KIDNEY DISEASE PATIENTS

Abstract

Background: CKD (Chronic Kidney Disease) is a progressive disorder with systemic complications that extend beyond renal impairment, often manifesting as ocular changes. The retina, sharing structural and microvascular similarities with renal tissue, serves as a window to systemic vascular health. Retinal abnormalities such as hypertensive and diabetic retinopathy frequently accompany CKD, reflecting the disease’s severity and progression. Evaluating these fundus changes can aid in early detection, timely management, and prevention of visual morbidity in CKD patients.

Methods: This descriptive cross-sectional, hospital-based study was conducted at Gandhi Hospital over 18 months, including 150 CKD patients aged 20–65 years from all disease stages. After obtaining informed consent, participants underwent detailed ocular history assessment, slit-lamp examination, and fundus evaluation using direct and indirect ophthalmoscopy. Data were analyzed using the chi-square test to determine correlations between fundus changes and disease severity.

Results: Among 150 participants, 70% were male and 30% female, with the majority (41.33%) aged 51–65 years. The most common etiology for CKD was hypertension (58.67%), followed by diabetes mellitus (21.33%), and both (20%). Fundus abnormalities were noted in 79.33% of patients. Hypertensive retinopathy was predominant-Grade I (23.33%), Grade II (12.67%), Grade III (4%), and Grade IV (2.66%)-while diabetic retinopathy included mild NPDR (10.67%), moderate NPDR (8.67%), severe NPDR (4.66%), and PDR (9.33%). Mixed retinopathy accounted for 3.33% of cases.

Conclusion: Ocular manifestations are common in CKD, with hypertensive and diabetic retinopathies being the most frequent. Fundus examination serves as a valuable non-invasive tool for assessing systemic vascular damage and disease progression. Routine ophthalmologic screening in CKD patients is essential for early detection and prevention of visual complications, emphasizing the need for multidisciplinary management.