Assessment of Fundus Changes in Patients With Chronic Kidney Disease in a Tertiary Health Care Centre in Coimbatore

METHODOLOGY:

1. CKD patients reported with ocular anomalies to the Department of

Ophthalmology / referred by the Department of General Medicine will

be undertaken as subject for the Prospective Observational Study

2. Fundus examination for the patients will be carried out under eye

examination unit and instruments like slit lamp bio microscope,

Retinoscope (mirror and streak), Direct and indirect ophthalmoscope

will be used and adequate data will be collected

3. Following appropriate protocol, assuring quality control, and assessing

through standard calibrated instruments, morphology findings will be

captured (colored and labelled pictures)and categorized. Data collected

will be recorded with the help of various statistical tools

4. Through maintaining confidentiality and following ethical principles, the

data collected from the patient population will be analyzed and

categorized according to varying degree of fundus changes

5. Fundus anomalies like DR, PDR, NPDR, Hypertensive retinopathy,

Mixed retinopathy, Venous occlusions, Age related Macular

Degeneration Drusen like deposits, Optic atrophy and retinal

detachment are categorized and segregated in groups. Incidence and

proportion of varying fundus changes in a tertiary health care centre is

reported

Prior studies indicated a high prevalence of ocular fundus pathology among patients with chronic kidney disease (CKD). The risk of development of retinopathy was significantly higher among older patients those with low haemoglobin level and high blood pressure. Retinopathy was significantly increased with reduction of e-GFR.

There was no direct significant relationship between BMI and serum lipid levels with retinal abnormality. The current study provides the morphological changes of fundus and the****proportion of varying degree of fundus changes in CKD patients in a tertiary health care centre, Coimbatore, Tamil Nadu. Thus it assist in improving the treatment protocols in terms of whether to treat or not treat/ whether to intensify or not to intensify therapy in order to minimise the major avoidable fundus complications in chronic kidney failure patients and this helps to narrow down ocular complications in advance.