Evaluation Of Ocular Parameters In Patients Receiving Hemodialysis Treatment
Ocular Findings in Hemodialysis Patientes
Abstract views: 96
/ 
PDF downloads: 43
DOI:
https://doi.org/10.5281/zenodo.11215239Keywords:
Ganglion cell layer, hemodialysis, inner plexiform layer, choroid thicknessAbstract
Background: Changes in retrobulbar blood flow during hemodialysis (HD) may result in ocular changes. It may have effects especially on the choroid, which is the area with high blood flow, and therefore the retina. This study aims to compare choroidal and retinal changes before and after a single HD session.
Methods: In this prospective study, patients receiving HD treatment in the dialysis unit between October 2022 and February 2023 were included. The patients were divided into two groups: diabetes mellitus (DM) and non-DM. Measurements were made before and after dialysis treatment using optical coherence tomography. Using computerized segmentation, macular retinal layer volumes of the eye (total retinal volume and ganglion cell layer from outside to inside, inner plexiform layer) were measured. The enhanced depth imaging system of optical coherence tomography was used to measure choroidal thickness.
Results: A total of 28 patients (18 women and 10 men) participated the study. All patients underwent in-depth eye examination. After the HD session, a statistically significant decrease in choroidal thickness was observed in the macula temporal, subfoveal region, macula nasal, and optic disc nasal in both the DM and non-DM groups. According to the measurements made on the retinal layers before and after HD, it was observed that there was no change in the macular thickness of the ganglion cell layer and inner plexiform layer.
Conclusion: The lack of change in the macular thickness of the ganglion cell layer and inner plexiform layer suggested that HD did not have any effect on the neural tissue. Thinning was observed in the choroidal layer after hemodialysis. It was observed that HD affected choroidal blood flow and caused changes in the vascular layer of the eye. Changes in the choroidal tissue in the optic disc nasal and posterior pole regions also suggest that HD affects the vascular layer of the eye globally.
References
Murdeshwar HN, Anjum F. Hemodialysis. [Updated 2023 Apr 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563296/
Zhang X, Yuan Y. Effect of replacement therapy (CRRT) and hemodialysis (IHD) on severe acute renal failure. Front Pharmacol. 2023;14:1122778. Published 2023 Jul 21. doi:10.3389/fphar.2023.1122778.
Wang L, Yin G, Yu Z, Chen N, Wang D. Effect of Hemodialysis on Eye Coats, Axial Length, and Ocular Perfusion Pressure in Patients with Chronic Renal Failure. J Ophthalmol. 2018;2018:3105138. Published 2018 Feb 8. doi:10.1155/2018/3105138
Dolar-Szczasny J, Flieger J, Kowalska B, et al. Hemodialysis Effect on the Composition of the Eye Fluid of Cataract Patients. J Clin Med. 2021;10(23):5485. Published 2021 Nov 23. doi:10.3390/jcm10235485
Aumann S, Donner S, Fischer J, Müller F. Optical Coherence Tomography (OCT): Principle and Technical Realization. In: Bille JF, ed. High Resolution Imaging in Microscopy and Ophthalmology: New Frontiers in Biomedical Optics. Cham (CH): Springer; August 14, 2019.59-85.
Campochiaro PA. Molecular pathogenesis of retinal and choroidal vascular diseases. Prog Retin Eye Res. 2015;49:67-81. doi:10.1016/j.preteyeres.2015.06.002
Reiner A, Fitzgerald MEC, Del Mar N, Li C. Neural control of choroidal blood flow. Prog Retin Eye Res. 2018;64:96-130. doi:10.1016/j.preteyeres.2017.12.001
Almaznai A, Alsaud S, Fahmy R. Ocular parameters alterations after hemodialysis in patients with chronic kidney diseases. Saudi J Ophthalmol. 2021;35(1):9-14. Published 2021 Sep 9. doi:10.4103/1319-4534.325775
Chen H, Zhang X, Shen X. Ocular changes during hemodialysis in patients with end-stage renal disease. BMC Ophthalmol. 2018;18(1):208. Published 2018 Aug 23. doi:10.1186/s12886-018-0885-0
Ruan Y, Jiang S, Gericke A. Age-Related Macular Degeneration: Role of Oxidative Stress and Blood Vessels. Int J Mol Sci. 2021;22(3):1296. Published 2021 Jan 28. doi:10.3390/ijms22031296
Tokuyama T, Ikeda T, Sato K. Effect of plasma colloid osmotic pressure on intraocular pressure during haemodialysis. Br J Ophthalmol. 1998;82(7):751-753. doi:10.1136/bjo.82.7.751
Çelikay O, Çalışkan S, Biçer T, Kabataş N, Gürdal C. The Acute Effect of Hemodialysis on Choroidal Thickness. J Ophthalmol. 2015;2015:528681. doi:10.1155/2015/528681
Jung JW, Yoon MH, Lee SW, Chin HS. Effect of hemodialysis (HD) on intraocular pressure, ocular surface, and macular change in patients with chronic renal failure. Effect of hemodialysis on the ophthalmologic findings. Graefes Arch Clin Exp Ophthalmol. 2013;251(1):153-162. doi:10.1007/s00417-012-2032-6
Theodossiadis PG, Theodoropoulou S, Neamonitou G, et al. Hemodialysis-induced alterations in macular thickness measured by optical coherence tomography in diabetic patients with end-stage renal disease. Ophthalmologica. 2012;227(2):90-94. doi:10.1159/000331321
Nakano H, Hasebe H, Murakami K, et al. Choroid structure analysis following initiation of hemodialysis by using swept-source optical coherence tomography in patients with and without diabetes. PLoS One. 2020;15(9):e0239072. Published 2020 Sep 11. doi:10.1371/journal.pone.0239072
Jung S, Bosch A, Ott C, et al. Retinal neurodegeneration in patients with end-stage renal disease assessed by spectral-domain optical coherence tomography. Sci Rep. 2020;10(1):5255. Published 2020 Mar 24. doi:10.1038/s41598-020-61308-4
Lee WJ, Hong R, Kang MH, et al. Effect of Hemodialysis on Peripapillary Choroidal Thickness Measured by Swept-Source Optical Coherence Tomography. J Glaucoma. 2021;30(6):459-464. doi:10.1097/IJG.0000000000001762
Chang IB, Lee JH, Kim JS. Changes in Choroidal Thickness in and Outside the Macula After Hemodialysis in Patients With End-Stage Renal Disease. Retina. 2017;37(5):896-905. doi:10.1097/IAE.0000000000001262
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2024 Müge Toprak, Kemal Mağden
This work is licensed under a Creative Commons Attribution 4.0 International License.
The journal is licensed under a 