Idiopathic Nephrotic Syndrome (NS) is the most common glomerulopathy in childhood, the annual incidence is estimated to be 2‐7 per 100,000 children [1]. The classic features of this syndrome are edema, proteinuria, hypoalbuminemia, and hyperlipidemia [2]. Idiopathic NS can be classified based on the response to steroid therapy, the pattern of relapse, histopathology, or genetic mutations. It is categorized as steroid-sensitive (SS) or steroid-resistant (SR) based on the response to steroid therapy [3]. Minimal change disease (MCD), the most common cause of childhood NS, generally responds to corticosteroids and usually goes into remission within the 4 weeks following that. However, there is a high risk of relapse after corticosteroids have been stopped [4]. Another common cause of NS is focal segmental glomerulosclerosis (FSG), which is usually resistant to corticosteroids and can progress to end-stage renal failure [5].

The chronic and recurrent nature of the disease poses a great challenge in its management. The mainstay of treatment is still systemic corticosteroids. Non-steroidal immunosuppressive drugs such as cyclosporine A, cyclophosphamide, and levamisole are sometimes used in steroid-resistant or steroid intolerant patients [6]. The drugs used in the treatment of NS may cause complications with significant morbidity over time.

The Pentacam HR (Oculus Inc., Wetzlar, Germany) includes a rotating Scheimpflug camera that can non-invasively capture images from the front of the cornea to the posterior surface of the lens [7]. With this imaging system, corneal topography, corneal pachymetry, anterior chamber analysis, and corneal and lens optical densities can be evaluated. Densitometry is an objective, precise and reproducible parameter for corneal and lens transparency, and allows measuring the intensity of backscattered light from different regions of the cornea and lens. High densitometry values associated with increased backward scattering can be observed even in clinically transparent corneas and lenses. Therefore, it has been used in many recent studies to evaluate corneal and lens health [8,9].

This study aimed to compare the corneal and lens densitometry values between children with NS and healthy individuals. To the best of our knowledge, this is the first study to examine corneal and lens densitometry using Pentacam HR in NS.