Date Published: June 28, 2017
Publisher: Public Library of Science
Author(s): Yuh-Shin Chang, Shih-Feng Weng, Chun Chang, Jhi-Joung Wang, Hong-I Chen, Shun-Yao Ko, I-Te Tu, Chih-Chiang Chien, Jian-Jhong Wang, Ching-Min Wang, Ren-Long Jan, Abelardo I Aguilera.
The aim of this retrospective, nationwide, matched cohort study was to investigate the association of serous retinal detachment with having end-stage renal disease (ESRD) while on dialysis. The cohort study included 94,024 patients with ESRD on dialysis registered between January 2000 to December 2009 in the Taiwan National Health Insurance Research Database. An age- and sex-matched control group comprised 94,024 patients selected from the Taiwan Longitudinal Health Insurance Database 2000. Information for each patient was collected from the index date until December 2011. Twenty-seven ESRD patients and 11 controls developed serous retinal detachment (P < 0.001) during follow-up, demonstrating a significantly increased risk of serous retinal detachment in patients with ESRD on dialysis compared with controls (incidence rate ratio = 3.39, 95% confidence interval [CI] = 1.68–6.83). After adjustment for potential confounders, patients were 3.86 times more likely to develop serous retinal detachment than the full cohort (adjusted HR = 3.86, 95% CI = 1.15–12.96). In conclusion, patients with ESRD on dialysis demonstrate an increased risk of serous retinal detachment. Interdisciplinary collaboration between nephrologists and ophthalmologists is important to deal with serous retinal detachment in patients with ESRD on dialysis and prevent impairments of visual acuity.
End-stage renal disease (ESRD), the most severe form of chronic kidney disease, is known as a worldwide public health problem. ESRD often requires dialysis or kidney transplantation because of the poor prognosis owing to morbidity and mortality [1–3]. The prevalence and incidence of patients with ESRD on dialysis have continued to increase in both Western and Asian populations [4,5]. Taiwan has the highest incidence and prevalence of patients with ESRD on dialysis [6–8]. Furthermore, the association between ESRD and many retinal diseases, such as retinal artery occlusion, retinal vein occlusion, or age-related macular degeneration, has been demonstrated by several reports recently [9–11].
This cohort study is the largest-scale population-based study that has been conducted to explore the association between having ESRD while on dialysis and subsequent serous retinal detachment. We analysed 94,024 patients with ESRD on dialysis and 94,024 control subjects and found that the incidence rate of serous retinal detachment in patients with ESRD on dialysis was 3.39 times higher than in controls. Furthermore, the study also showed that the risk of serous retinal detachment for patients with ESRD on dialysis was 3.86 times higher in both groups after adjusting for diabetes mellitus, chorioretinal inflammation, and malignant neoplasm of eye.