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Objective: Children with chronic kidney diseases (CKD) are at risk for neurological diseases at early adulthood. Spectral-domain optical coherence tomography (SD-OCT) of the retina is especially suitable for determination of intraretinal layer thickness. We wonder whether retinal thinning is already present in pediatric patients with mild-to-moderate CKD. Patients and Methods: Children (n = 15; 14.9 ± 2.4 years) with mild-to-moderate CKD (median eGFR of 95ml/min/1.73m2; range: 28-187ml/min/1.73m2) due to glomerulopathy, congenital anomalies of kidney and urinary tract (CAKUT), or haemolytic uremic syndrome (HUS) underwent a detailed ophthalmologic examination including high-resolution SD-OCT. Three OCT scans were obtained from the right eyes of all patients. Within each scan, retinal layers were separated and the mean thickness was determined at the foveal, parafoveal, and perifoveal area. The results were compared to those we obtained previously from healthy children. Results: At the parafoveal area, thickness (median, range) of the total retina (ALL), ganglion cell layer (GCL), and inner plexiform layer (IPL) were reduced compared to healthy volunteers (339µm, (288-361µm) vs. 348µm, (320-385µm); 49.8µm (30.5-56.6µm) vs. 53.5μm (49.5-60.5µm) and 41.0µm (29.4-43.7µm) vs. 43.46µm (39.5-46.3μm); each p < 0.05). The intraretinal thickness measurements at the foveal and perifoveal areas revealed no statistically significant differences between patients and controls. Conclusion: Distinct changes within the parafoveal area of the total retina, GCL, and IPL are present in children with mild-to-moderate CKD. Prospective studies are required to assess the clinical significance of our findings. [ABSTRACT FROM AUTHOR]

Optical coherence tomography (OCT) enables noninvasive high-resolution 3D imaging of the human retina, and thus plays a fundamental role in ophthalmology. Via OCT examination, even subtle retinal changes can be captured, which occur in very early stages of different diseases (e.g., glaucoma, diabetes mellitus, or age-related macular degeneration). Yet, analyzing the resulting data is challenging. Conventionally, OCT data are strongly aggregated via automated methods. While this reduces the amount of information to be analyzed, it also makes it difficult, if not impossible, to identify small and localized retinal changes. This might lead to wrong diagnoses, since these methods do not account for patient-specific characteristics. We address this problem by providing new and efficient visual-interactive methods. Particularly, we introduce dedicated visualizations that show different aspects of the data. In addition, we support patient-specific selections of relevant data regions. Selected regions are emphasized, or separately visualized to inspect retinal substructures in detail. By visually comparing the regions to reference data, even very small retinal changes can be detected. We demonstrate the utility of our approach by applying it to data of a study with pediatric patients suffering from diabetes mellitus type 1. Our results show that visual-interactive methods indeed help to analyze subtle retinal changes and, thus, support the diagnosis of diseases in an early stage., Competing Interests: Interessenkonflikt: Die Autoren geben an, dass kein Interessenkonflikt besteht., (Georg Thieme Verlag KG Stuttgart · New York.)