Purpose: Chronic kidney disease (CKD) is an emerging health problem worldwide. In CKD corneal endothelial changes also occur probably due to accumulation of inflammatory cytokines and increased multiple toxic products. The aim of this study was to analyze the effect of CKD on corneal endothelium and correlate the findings with severity of disease with help of noninvasive technique. Methods: The study comprised 75 eyes of 75 cases divided into three groups with group A comprising of CKD cases on dialysis, group B of nondialysis CKD cases, and group C of controls. Each group had 25 cases each of either sex and between 15–80 age groups. All patients were investigated for blood urea, serum creatinine, and blood sugar and underwent complete ophthalmic examination of both eyes along with wide-field specular microscopy examination. Results: The majority of patients (33.3%) belonged to age range of 61–70 years with male predominance and the most common cause of CKD was found to be diabetes with 17 (34%) cases. We found normal corneal endothelial cell density (ECD) with the mean ECD of 2364.52 ± 397.72 mm 2 in the dialysis group, 2467.8 ± 352.88 mm 2 in nondialysis group, and 2521.68 ± 250.26 mm 2 in the control group of patients. However, we found significant increase in coefficient of variation (CV) with 36 ± 5.8% in dialysis group, 37 ± 4.5% in nondialysis group and 32 ± 0.8% in controls ( P = 0.001) and decreased hexagonality (Hx) with 47 ± 7.3% in dialysis group, 46 ± 4.7% in nondialysis group and 51 ± 6.7% in the controls ( P = 0.031). This showed increased tendency of pleomorphism and polymegathism in corneal endothelial cells in CKD cases. No correlation was found between blood urea or serum creatinine levels with endothelial parameters in any group. Conclusion: CKD causes morphological changes like polymegathism and pleomorphism in corneal endothelium and hence these cases are more vulnerable and special care should be taken before any intraocular surgical procedure.
Background: The aim was to study the demographic profile and analyze risk factor associated with dry eye disease in North West Rajasthan, India.Methods: This was a hospital-based study conducted in Department of Ophthalmology, Sardar Patel Medical College, Bikaner, Rajasthan. Sample size of this study was 100 patients. All participants underwent a general ophthalmic assessment including history of any previous ocular and systemic illness along with ocular examination on slit lamp and specific tests for dry eye (Schirmer's test and Tear film break up time) were performed.Results: Dry eye were seen maximum in age group 46 to 60 years (41%), followed by 61-75 years (23%). Female’s preponderance was seen compared with male. Dry eye patients belong from rural areas were (57%) while remaining (43%) from urban areas and among these highest were farmer/labourers (32%). Several known risk factors were found in this study which include post-menopause. Climatic condition like excessive wind, high temperature and computers users had strong association with dry eye. In Systemic disease rheumatoid arthritis was commonly associated with dry eye were. Smoking contact lens use were also associated with increased risk of developing dry eye.Conclusions: Dry eye disease are more common in older age group patients. Female’s preponderance were found in the study especially postmeopausal women. Dry eye disease are more common in patients belongs to rural areas. Risk factor associated with dry eye were Climatic condition like excessive wind, high temperature and computers users, systemic disease like rheumatoid arthritis Smoking, contact lens users.
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