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

Abstract

The purpose of this study was to investigate the frequency of ocular manifestations in hemodialysis (HD) patients and short‐term changes in ophthalmologic findings. A total of 142 eyes of 71 HD patients were included in this study. Patients with corneal and conjunctival deposits, diabetic retinopathy, hypertensive retinopathy, cataract, optic atrophy, or glaucoma were recorded. Schirmer I tests and the tear break up time (TBUT) were performed in the listed order to evaluate dry eye. Axial length (AL) and anterior chamber depth (ACD) were measured using ultrasound biometry using an infrared system. The TBUT test, Schirmer I test, intraocular pressure, AL, and ACD were applied within 30 minutes before and after a single session of HD. The most common ocular findings included conjunctival calcification (60.6%), cataract (50.7%), and proliferative diabetic retinopathy (21.1%). The average TBUT results decreased from 10.81 ± 4.90 to 9.43 ± 4.78 seconds after HD, and was statistically significant (P < .001). The mean Schirmer I test results decreased from 13.59 ± 4.67 to 12.07 ± 4.86 mm after HD. The decline in the Schirmer I test results was statistically significant (P = .005). The mean intraocular pressure decreased from 14.57 ± 4.40 to 13.43 ± 3.91 mm Hg after HD, and was statistically significant (P < .001). The mean ACD increased from 3.19 ± 0.53 to 3.25 ± 0.55 mm, and the mean AL increased from 23.05 ± 1.35 to 23.13 ± 1.35 mm, both increases being significant after HD (both P < .001). Eye diseases such as diabetic retinopathy, corneo‐conjunctival calcification, and dry eye are common in HD patients; these patients should undergo early and frequent eye examinations.

Effect of Optimization of Hemodialysis on Ophthalmological Variables in Patients with End Stage Renal Disease

“…Ocular effects of HD can vary significantly, ranging from dry eye, corneal erosion, band keratopathy, perilimbal calcium deposits, posterior subcapsular cataract, intraocular pressure (IOP) changes, thickness changes in the central cornea (CCT), retinal nerve fiber layer, and choroid to retinal hemorrhage, retinal detachment, and macular edema. Best corrected visual acuity (BCVA) increases following a single HD session [2] [3] [4].…”

The impact of scheduled hemodialysis on clinical-functional and morphometric ophthalmological status of patients with a terminal kidney disease

“…Кальцификация конъюнктивы у диализных больных, по данным A. Ismayilov и соавт. [6], встречается в 60,6 % случаев, ее связывают с нарушением фосфорно-кальциевого обмена [7]. H. Chen и соавт.…”

“…У больных тХПН, получающих программный ГД, нередко диагностируют ССГ. Установлено, что сеанс диализа индуцирует уменьшение времени разрыва слезной пленки, снижение базальной секреции слезы, способствует усилению кератоэпителиопатии, в ряде случаев обусловливающей понижение остроты зрения [6,8,9,[11][12][13][14]. Данные изменения находятся в связи с интрадиализным повышением коллоидно-осмотического давления плазмы крови [11].…”

“…Данные литературы, посвященные состоянию размерных характеристик ПК глаза у больных, находящихся на ГД, немногочисленны и противоречивы. У пациентов, не имеющих признаков глаукомы, глубина ПК (ГПК) может оставаться стабильной [18,21,30], уменьшаться [8,[31][32][33] либо увеличиваться [6].…”

“…Иной результат получен A. Ismayilov и соавт. [6]. Через 30 мин после завершения сеанса лечения ими зафиксировано статистически значимое углубление ПК -на 0,06 мм (с 3,19 ± 0,53 до 3,25 ± 0,55 мм; р = 0,001).…”