Epidemiology of Common Ocular Manifestations among Patients on Haemodialysis in West Bank, Palestine

Abstract

Objectives: To assess the prevalence of ocular manifestations and associated factors in patients on haemodialysis. Methods: A cross-sectional study of 191 patients on haemodialysis from a haemodialysis unit in Nablus, Palestine. Medical examination for ocular manifestations (intraocular pressure, cataract, retinal changes, and optic neuropathy) was performed using Tono-Pen, portable slit-lamp, and indirect ophthalmoscope. Predictor variables were age, gender, smoking, medical comorbidities (diabetes, hypertension, ischemic heart disease (IHD), and peripheral arterial disease (PAD)), and use of antiplatelet or anti-coagulation medications. Results: The prevalence of any ocular manifestation in at least one eye was 68%. The most common ocular manifestations were retinal changes (58%) and cataract (41%). The prevalence of non-proliferative diabetic retinopathy (NPDR), preoperative diabetic retinopathy (PDR), and either NPDR or PDR was 51%,16%, and 65%, respectively. Increase in age by one year was associated with increase in the odds of having cataract by 1.10 (95% confidence interval (CI), 1.06, 1.14). Patients with diabetes had higher odds of having cataract (odds ratio (OR) 7.43; 95% CI, 3.26, 16.95) and any retinal changes (OR 109.48, 95% CI, 33.85, 354.05) than patients without diabetes. Patients with diabetes and IHD or PAD had higher odds of having NPDR than patients with diabetes and free from IHD or PAD (OR 7.62; 95% CI, 2.07, 28.03). Conclusion: Retinal changes and cataract are very common ocular manifestations among patients on haemodialysis. The findings emphasize the importance of periodic screening for ocular problems this vulnerable population, especially older patients and those with diabetes, to prevent visual impartment and associated disability.
 Keywords: Kidney Failure, Chronic; Renal Dialysis; Eye Diseases; Eye Manifestations; Cross-Sectional Studies.