Corneal and Lens Densitometry Changes Noted in Pediatric Nephrotic Syndrome

Disease duration, the number of attacks, and total steroid dose affect changes in corneal and lens densitometry in children with nephrotic syndrome (NS), according to a study published in Photodiagnosis and Photodynamic Therapy. Changes were most evident at the level of the anterior cornea and central 0-6 mm area.

Researchers included  23 children with NS (mean age, 11.21 years; 78.3% boys) and 26 sex- and age-matched control individuals (mean age, 10.53 years; 73.1% boys) in a prospective, nonrandomized, cross-sectional study. Participants underwent corneal topography and corneal and lens densitometry measurements. Correlations between steroid cumulative dose, age at disease diagnosis, disease duration, relapses, and densitometry values were obtained following a review of patients’ records.

Keratometry (K) values were lower among children with NS compared with children in the control group (Kmean anterior, 42.86 vs 43.80 diopters [D]; Kmean posterior, 6.19 vs 6.40 D; Kmax, 43.83 vs 44.71; P ≤.040 for all), while horizontal white-to-white distance (11.98 vs 11.67 mm; P =.008) and iridocorneal angle (40.06 vs 36.93; P =.043) were greater. Overall, 0-2 mm and 2-6 mm anterior corneal densitometry values were higher among children in the NS group compared with the control group (P =.009 and P =.033, respectively). 

Eyes with NS exhibited higher lens densitometry values compared with eyes in the control group in all zones, but these values failed to achieve statistical significance. The investigators uncovered a strong correlation between the cumulative steroid dose and the posterior lens zone densitometry. There were positive, but weak correlations between the number of attacks and anterior corneal densitometry, and between disease duration and central corneal densitometry and mean lens density, according to the report.

“[I]n eyes with NS, changes occur in corneal and lens densitometry in correlation with disease duration, the number of attacks, and cumulative steroid dose,” according to the study authors. “Densitometry measurements can provide an objective and quantitative assessment of early complications before they reach a level that can be detected biomicroscopically.”

A small sample size and potential confounding due to combined therapies are acknowledged limitations to the research.