Advanced OCT-A Imaging Can Identify Kidney Disease Biomarkers in Diabetic Patients

Swept-source OCT-A imaging of the retina’s nonperfusion area (NPA) may predict diabetic nephropathy (DN) and chronic kidney disease (CKD) in patients with diabetes, says a recent study published in American Journal of Ophthalmology. SS-OCTA is commonly used to scan for AMD and diabetes-related conditions, including diabetic retinopathy and CKD. Photo: National Kidney Foundation. Click image to enlarge.Diabetic nephropathy is a form of kidney damage caused by prolonged high blood sugar. It causes damage to the kidney’s filtration system, eventually leading to chronic kidney disease and failure. While DN risk can be predicted using other methods, the researchers explain that “current biomarkers are very limited in their ability to prognosticate chronic kidney disease progression due to poor sensitivity.” They elaborated that the “ideal biomarker” of CKD “should be easy to measure, noninvasive, highly reproducible with high sensitivity and specificity, and cost effective.”Swept-source OCT-A differs from its spectral-domain OCT-A in that it offers a stronger light source for better tissue penetration and better blood flow imagery. In the context of this study, it was used to identify markers of DN at various stages.Research was conducted on 234 diabetic patients (375 eyes) ages 18 to 90 over the span of two years. All patients had a minimum 20/200 Snellen BCVA, and both type 1 and type 2 diabetes were included—the authors noted that 83.8% of patients had type 2 diabetes and that, in total, subjects had had the disease for a median of 16 years. In addition, 53.4% of patients were male and 50.9% were white. Another condition of note was diabetic retinopathy (DR)—48 eyes (12.8%) did not present with DR, 190 (50.7%) had early-stage DR and 137 (36.5%) had advanced DR.Before processing the OCT-A images, the researchers performed ophthalmic examinations on each patient, “including BCVA, intraocular pressure (IOP) measurement, slit lamp and dilated fundus examination,” according to the paper. Images were filtered for quality and analyzed, with emphasis on the presence of albuminuria—a condition where the protein albumin leaks from the blood to the urine, signifying kidney damage—and CKD. Albuminuria was found in 62% of patients and CKD was found in 47%.The authors concluded that “quantitative OCT-A metrics can function as noninvasive tests that are associated with DN severity.” In particular, this includes “patients at high risk for mortality and CKD severity,” for whom practitioners can create specific treatment plans that account for their individual health conditions and needs.Click here for the journal source. Garg I, Duich M, Uwakwe C, et al. Swept-source OCT angiography vascular metrics as biomarkers for renal function in patients with diabetes mellitus. Am J Ophthalmol. March 12, 2026. [Epub ahead of print].  This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.