The purpose of this article is to investigate the relationship between renal function and disc hemorrhage (DH).
This retrospective cross-sectional survey was conducted at Kangbuk Samsung Hospital Health Screening Center between August 2012 and July 2013, and a total of 168,044 participants at least 20 years of age who voluntarily visited the health screening center for systemic and ophthalmologic examinations, including fundus photography, were enrolled. All subjects underwent a physical examination and provided samples for laboratory analysis. Digital fundus photographs of both eyes were taken and reviewed. Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine concentration using the Modification of Diet in Renal Disease (MDRD) formula and Cockcroft-Gault (CG) formula. Subjects were stratified by eGFR into quartiles.
Among participants, 220 (0.1%) showed DH, and 2376 (1.6%) showed glaucomatous retinal nerve fiber layer defects. The DH group showed higher creatinine and lower eGFR than the non-DH group. A significant trend was observed among higher creatinine, decreased eGFR as obtained by the MDRD and CG formulas, and the prevalence of DH (P for trend ≤0.003, logistic regression analysis). A multiple logistic regression model adjusted for age, sex, hypertension, diabetes, and hyperlipidemia showed that the lowest eGFR quartiles estimated by MDRD and CG were significantly associated with DH compared with the highest eGFR quartile (adjusted odds ratio, 1.96; 95% confidence interval, 1.22-3.14 by CG, 1.86; 95% confidence interval, 1.17-2.96 by MDRD).
Renal function impairment was independently associated with a higher prevalence of DH in a South Korean population.
Departments of *Ophthalmology
§Internal Medicine, Division of Nephrology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
‡Department of Ophthalmology, Korea University College of Medicine
∥Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
J.Y.L. and S.H.S.: contributed to the analysis and interpretation of the data; drafted the work. J.M.K.: made substantial contributions to the conception and design of the work; drafted the work and revised it critically for important intellectual content. Y.Y.H., C.Y., and K.H.P.: contributed to the conception and design of the work and revised it critically for important intellectual content. Y.S.W.: contributed to revising this critically for important intellectual content. J.Y.L.: contributed to the analysis and interpretation of the data.
Disclosure: The authors declare no conflict of interest.
Reprints: Joon Mo Kim, MD, PhD, Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea (e-mail: email@example.com).
Received August 14, 2017
Accepted December 22, 2017