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Title: Increased retinal drusen in IgA glomerulonephritis are further evidence for complement activation in disease pathogenesis.
Austin Authors: Harraka, P;Wightman, Tony;Akom, Sarah;Sandhu, Kieran;Colville, Deb;Catran, Andrew;Langsford, David;Pianta, Timothy;Barit, David;Ierino, Frank;Skene, Alison ;Mack, Heather;Savige, Judy
Affiliation: Department of Medicine, Northern Health, The University of Melbourne, Parkville, VIC, 3050, Australia.
The University of Melbourne Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC 3002, Australia.
Issue Date: 31-Oct-2022
Date: 2022
Publication information: Scientific Reports 2022
Abstract: Drusen are retinal deposits comprising cell debris, immune material and complement that are characteristic of macular degeneration but also found in glomerulonephritis. This was a pilot cross-sectional study to determine how often drusen occurred in IgA glomerulonephritis and their clinical significance. Study participants underwent non-mydriatic retinal photography, and their deidentified retinal images were examined for drusen by two trained graders, who compared central drusen counts, counts ≥ 10 and drusen size with those of matched controls. The cohort comprised 122 individuals with IgA glomerulonephritis including 89 males (73%), 49 individuals (40%) of East Asian or Southern European ancestry, with an overall median age of 54 years (34-64), and median disease duration of 9 years (4-17). Thirty-nine (33%) had an eGFR < 60 ml/min/1.73 m2 and 72 had previously reached kidney failure (61%). Overall mean drusen counts were higher in IgA glomerulonephritis (9 ± 27) than controls (2 ± 7, p < 0.001). Central counts ≥ 10 were also more common (OR = 3.31 (1.42-7.73, p = 0.006), and were associated with longer disease duration (p = 0.03) but not kidney failure (p = 0.31). Larger drusen were associated with more mesangial IgA staining (p = 0.004). Increased drusen counts were also present in IgA glomerulonephritis secondary to Crohn's disease but not with Henoch-Schonlein purpura. The finding of retinal drusen in IgA glomerulonephritis is consistent with complement activation and represents a model for better understanding glomerular immune deposition and a supporting argument for treatment with anti-complement therapies.
DOI: 10.1038/s41598-022-21386-y
Journal: Scientific Reports
Start page: 18301
PubMed URL: 36316518
ISSN: 2045-2322
Type: Journal Article
Subjects: glomerulonephritis
retinal drusen
Retinal Drusen/etiology
Glomerulonephritis, IGA/complications
Complement Activation/physiology
Appears in Collections:Journal articles

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