Purpose: Macular edema, serous retinal detachment, and retinal pigment epithelial detachment have been reported in patients with nephrotic syndrome. However, there is limited data about macular thickness in children with nephrotic syndrome. The aim of this study was to compare the mean macular thickness in children with nephrotic syndrome and in a control group and to correlate it with visual acuity and level of proteinuria. Methods: The comparative cross-sectional study included 66 children aged 6 to 17 years with nephrotic syndrome and healthy control seen in two tertiary centers in Malaysia. We recorded demographic data, as well as visual acuity, level of proteinuria, and the mean macular thicknesses in both groups. The mean macular thickness was measured using Stratus optical coherence tomography according to nine areas of the Early Treatment Diabetic Retinopathy Study map. Results: The mean foveal thickness was 238.15 ± 22.98 µm for children with nephrotic syndrome and 237.01 ± 22.60 µm for the control group. There was no significant difference in the mean macular thickness between the groups (p = 0.843). A significant correlation with visual acuity was observed in the superior outer macula (r = –0.41, p = 0.019), the nasal outer macula (r = –0.41, p = 0.019), and the inferior outer macula (r = –0.40, p = 0.021). There was no significant correlation between the mean macular thickness and level of proteinuria (p = 0.338), although those with higher levels of proteinuria demonstrated a trend towards increased macular thickness. Conclusions The mean macular thickness in children with nephrotic syndrome was similar to that of healthy children. A significant correlation between the mean thickness of the outer macular layer and the presenting visual acuity was observed. There was no correlation between the mean macular thickness and the level of proteinuria.

Introduction: Caring for children who have chronic kidney disease (CKD) is challenging. The goal of this study was to find out the prevalence of burnout and what factors contribute to it. We also want to know the correlation between caretaker’s strain and burnout. Methods: This was a cross-sectional study that involved caretakers of children with CKD. They were recruited from a university hospital in Kelantan, Malaysia. Self-administered questionnaire in Malay language comprised of Demographic Information Form, Copenhagen Burnout Inventory (CBI-M) and Caregiver Strain Index (CSI-M) was used. Results: Eighty-eight caretakers were involved in this study. The mean age of caretakers was 42 years old, majority were female (72.4%), Malay (99.0%) and Muslim (99.0%). The mean age of children with CKD was 11 years old, most of them were on medication (69.3%) and mean duration of illness was 4.6 years. The prevalence of burnout in all domains (personal, work-related, client-related) among the caretakers was 5.7%. Eight caretakers had personal burnout (9.1%) while five (5.7%) had client-related and work-related burnout respectively. Multiple linear regression showed positive association of duration since the initial diagnosis and total ward admission within six months with total burnout score. Pearson correlation revealed a positive and fair correlation between strain and burnout. Conclusion: Prevalence of burnout among caretakers was generally low, but personal burnout outnumbered other domains. Children with CKD with longer duration of illness and more frequent ward admission are the important factors leading to burnout among caretakers. A high number of caretakers having significant strain indicated that there were possibilities of developing burnout later on.