Intraocular pressure during haemodialysis: a review

Levy, Jaime; Tovbin, David; Lifshitz, Tova; Zlotnik, Moshe; Tessler, Zvi

doi:10.1038/sj.eye.6701755

Cited by 48 publications

(49 citation statements)

References 29 publications

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“…Results of published studies based on the effects of HD on IOP change can be classified into three groups [7]: reports showing IOP rise [4,[14][15][16][17][18], reports showing IOP decrease [19,20], and reports showing no significant change in IOP [21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

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Changes in intraocular pressure, and corneal and retinal nerve fiber layer thickness during hemodialysis

et al. 2010

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The aim of this study is to evaluate the changes in intraocular pressure (IOP), central corneal thickness (CCT), and retinal nerve fiber layer thickness (RNFLT) in patients with chronic renal failure undergoing hemodialysis (HD). A complete ophthalmological examination together with IOP, CCT, and RNFLT measurements were performed for each patient both before and after HD sessions. RNFLT parameters were detected by scanning laser polarimeter. Total body weight and serum osmolality were also measured. Only the left eyes were recruited for statistical analysis. Thirty-three eyes of 33 patients were enrolled in the study. Mean IOP decreased from 14.7 +/- 3.1 to 13.4 +/- 2.4 mmHg after HD (paired t test, P = 0.005). Mean CCT also decreased significantly after HD, from 556.5 +/- 33.5 to 550.2 +/- 34.6 mum (paired t test, P = 0.002). CCT change in the left eyes was found to be correlated with total body volume loss (Pearson correlation test, R = 0.391 and P = 0.030). Considering RNFLT parameters before and after HD, no significant alterations were detected by scanning laser polarimeter (paired t test, P > 0.05). We conclude that IOP may decrease to some extent after HD. CCT may be affected by fluid loss after HD sessions, with a resultant decrease in corneal thickness. In patients with chronic renal failure undergoing HD, RNFLT parameters can be measured as in healthy individuals. Underestimation of intraocular pressure values after HD sessions should be taken into account, especially in patients with chronic renal failure.

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Section: Discussionmentioning

confidence: 99%

“…In view of the fact that conflicting results have been reported concerning the effects of HD on IOP, the exact outcomes of HD on IOP are still not clear [7]. Osmotically active substances are eliminated by diffusion during HD, resulting in loss of body fluids and decrease in blood osmolality [8].…”

Section: Introductionmentioning

confidence: 99%

Changes in intraocular pressure, and corneal and retinal nerve fiber layer thickness during hemodialysis

et al. 2010

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“…This may be attributed to the methodological differences, such as different exclusion criteria, variable sample size and different tonometry techniques and possibly due to significant technical progress in the HD procedure itself over the years [28]. There are several studies, which demonstrate an elevation of IOP during an HD session [6][7][8][9][10][11][12][13][14][15].…”

Section: Association Of Iop and Hd-clinical Studiesmentioning

confidence: 99%

“…Some IOP readings were performed before and after HD, while others every 30 min, hourly, every 2 h or 2 h after the commencement of the HD session. Therefore, whether the conflicting results are due to different HD techniques or to discrepancies in IOP measurement techniques employed by the various authors remains as yet unclear [28]. Intraocular pressure is measured by various techniques (Goldmann, Perkins, Schiotz, pneumotonometer, air tonometer).…”

Section: Association Of Iop and Hd-clinical Studiesmentioning

confidence: 99%

Intraocular pressure changes during hemodialysis

et al. 2015

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The response of intraocular pressure (IOP) to hemodialysis procedure has been a subject of research throughout many decades. Several studies that evaluated the impact of hemodialysis (HD) on IOP have reported conflicting results and have drawn varied conclusions. Some studies have described an IOP elevation during HD, a finding they attributed to the osmotic disequilibrium between serum and aqueous humor induced by the HD procedure, especially when the facility of the outflow system is already compromised. On the other hand, several studies have reported a significant IOP decrease during HD. The majority of these studies supported the notion that the increase in plasma colloid pressure induced by fluid removal during the HD session is the underlying cause of decreased IOP. Finally, recent investigations did not establish a significant change in IOP measurements during HD. They have therefore suggested that improved dialysis techniques, such as high-flux HD, or hemofiltration and better urea control, maintain better osmolar balance and prevent a marked IOP elevation. Nevertheless, specific preventive measures are still necessary in HD patients with ocular pathologies (e.g., glaucoma) whose vision may be adversely influenced by significant IOP fluctuation.

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“…A systematic review concluded that the relationship was not clear. 1 Reports of IOP rise during HD in neovascular 2,3 and pseudo-exfoliative glaucoma are extremely limited. 4,5 Mechanisms for elevated IOP during HD are unclear; some authors propose that reduced plasma osmolality causes increased aqueous humour production and potential to elevate IOP.…”

Section: Commentmentioning

confidence: 99%