Evaluation of Dry Eye Using Anterior Segment Optical Coherence Tomography in Patients With End‐Stage Renal Disease Undergoing Hemodialysis

Abstract

The aim of the present study was to evaluate dry eye parameters with conventional tests and tear meniscus with Anterior Segment Optical Coherence Tomography (AS-OCT) in patients with end-stage renal disease (ESRD). Thirty-eight ESRD patients undergoing hemodialysis, and 40 healthy individuals were enrolled. An ocular surface disease index questionnaire (OSDI) was administered. Before conventional dry eye tests, tear meniscus were evaluated using AS-OCT. After a complete ocular examination, Schirmer and break-up time (BUT) tests were performed and probable corneal staining was investigated. Schirmer test and BUT values were significantly lower in ESRD patients (P < 0.05). OSDI scores and corneal staining scores were significantly higher in ESRD patients (P < 0.05). Tear meniscus height, tear meniscus depth, and tear meniscus area, which were obtained by AS-OCT were significantly lower in patients with ESRD (P < 0.05). Tear meniscus evaluation using AS-OCT is an effective and non-invasive method to assess tear meniscus in patients with ESRD. Patients with ESRD undergoing hemodialysis should obtain regular ophthalmic examination, especially for dry eye.

Ocular manifestations in hemodialysis patients and short‐term changes in ophthalmologic findings

“…It was further noted in the present study that, consistent with most other studies, Schirmer test and TBUT results decreased after HD 3 . Ebana Mvogo et al found that 27.1% of HD patients developed lacrimal hyposecretion 21 ; whereas Kal et al found that tear meniscus depth, tear meniscus area, and tear meniscus height were lower in patients with ESRD 10 . Anbar et al found that basal tear secretion and tear film stability were lower, whereas dry eye symptoms such as itching and redness were more common among children with ESRD.…”

“…In patients with corneal calcification, the mean TBUT was 8.0 ± 3.1 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12) seconds when compared to the patients with no corneal calcification (P = .036). In patients with corneal calcification, the Schirmer values of the patients were significantly lower when compared to the patients with no corneal calcification.…”

“…The mean duration of HD was 60 (16-264) months in patients with conjunctival calcification. In patients with conjunctival calcification, the mean TBUT was 8.3 ± 2.67 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12) seconds and the mean Schirmer I test was 12.11 ± 3.31 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) mm. The mean TBUT and Schirmer test results were significantly lower in patients with conjunctival calcification (P < .001, P = .002).…”

“…3 Ebana Mvogo et al found that 27.1% of HD patients developed lacrimal hyposecretion 21 ; whereas Kal et al found that tear meniscus depth, tear meniscus area, and tear meniscus height were lower in patients with ESRD. 10 Anbar et al found that basal tear secretion and tear film stability were lower, whereas dry eye symptoms such as itching and redness were more common among children with ESRD. A higher urea level in tears and decreased tear secretion after HD causes an increase in tear osmolarity.…”

“…9 Kal et al reported that tear meniscus area, tear meniscus height, and tear meniscus depth were significantly lower in patients with ESRD. 10 It has also been reported that retinal arteriole caliber did not change, but that retinal venules were dilated after HD. That said, some articles have found no changes in ocular parameters after HD.…”