Fundus changes in patients with chronic renal failure undergoing hemodialysis

Abstract

The assessment of renal vascular pathology requires invasive procedures. The retinal vasculature, conversely, can be observed noninvasively and therefore offers a unique opportunity to explore the association between systemic microvascular diseases and renal function.Aims: The study aims to highlight the importance of ocular screening in patients with chronic renal failure (CRF) on haemodialysis by analysing the fundus changes in these patients. Settings and design: This was a prospective observational study. Materials and Methods: 94 patients with CRF on haemodialysis were evaluated over a period of 6 months. Ocular examination included visual acuity, intraocular pressure measurement, slit lamp examination and fundus examination with indirect ophthalmoscope. Results: 60.64% of 188 eyes had visual acuity < 6/18. The most common causes of visual impairment were maculopathy in 68 eyes. The fundus findings included Hypertensive Retinopathy (HR) which was seen in 32 patients, followed by Diabetic Retinopathy (DR) in 22 patients, mixed retinopathy in 12 patients, Age-related macular degeneration (ARMD) in 9 patients, Retinal Detachment in 2 patients, glaucomatous optic atrophy in 1 patient and Vein Occlusion in 2 patient. Conclusion:The study highlights the importance of detailed ophthalmic examination in patients with CRF on haemodialysis. These patients should be followed up regularly in order to prevent further deterioration of retinal changes and visual loss. Since retinopathy is asymptomatic in its early stages, patients must be made aware of the ocular morbidity associated with CRF.