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Kim JH, Jeong HC, Shin YU, Lee WJ. Hemodialysis-induced positional changes in lamina cribrosa. Sci Rep 2024; 14:15250. [PMID: 38956090 PMCID: PMC11219866 DOI: 10.1038/s41598-024-65700-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 06/24/2024] [Indexed: 07/04/2024] Open
Abstract
This study is aimed to investigate the effect of hemodialysis (HD) on the lamina cribrosa (LC) of the optic nerve head (ONH) using swept-source optical coherence tomography (SS-OCT) and other ophthalmological parameters in patients with end-stage kidney disease (ESKD). This prospective observational study included 29 patients who underwent HD for ESKD. ONH parameters including neural canal diameter (NCD), peripapillary vertical height (PVH), and anterior LC depth (LCD), were assessed using SS-OCT. Changes in the ONH parameters before and after HD were statistically analysed. Correlations between changes in the LCD and other ocular and systemic measurements were identified using Pearson's correlation analyses. The mean anterior LCD significantly decreased from 441.6 ± 139.8 μm before HD to 413.5 ± 141.7 μm after HD (P = 0.001). Mean NCD and PVH did not show significant changes after HD (P = 0.841 and P = 0.574, respectively). A significant correlation was found between changes in the anterior LCD and the mean ocular perfusion pressure (r = 0.397, P = 0.036). We observed a significant decrease in anterior LCD after HD. Our study suggests that HD can influence the ONH, especially in the LC.
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Affiliation(s)
- Ji Hong Kim
- Department of Ophthalmology, Hanyang University College of Medicine, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 104763, Korea
- Department of Ophthalmology, Hanyang University Seoul Hospital, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 104763, Korea
| | - Hyo Chan Jeong
- Department of Ophthalmology, Hanyang University College of Medicine, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 104763, Korea
- Department of Ophthalmology, Hanyang University Seoul Hospital, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 104763, Korea
| | - Yong Un Shin
- Department of Ophthalmology, Hanyang University College of Medicine, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 104763, Korea
- Department of Ophthalmology, Hanyang University Guri Hospital, Guri, Korea
| | - Won June Lee
- Department of Ophthalmology, Hanyang University College of Medicine, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 104763, Korea.
- Department of Ophthalmology, Hanyang University Seoul Hospital, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 104763, Korea.
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2
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Swart G, Fraser CL, Shingde M, Thompson EO, Mallawaarachchi A, Lawlor M, Ahmad K, Halmagyi GM. Mitochondrial DNA 13513G>A Mutation Causing Leber Hereditary Optic Neuropathy Associated With Adult-Onset Renal Failure. J Neuroophthalmol 2024; 44:190-194. [PMID: 37477990 DOI: 10.1097/wno.0000000000001946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
BACKGROUND Leber hereditary optic neuropathy (LHON) is one of the more common mitochondrial diseases and is rarely associated with mitochondrial renal disease. We report 3 unrelated patients with a background of adult-onset renal failure who presented to us with LHON and were shown to have a heteroplasmic mitochondrial DNA mutation (m.13513G>A). METHODS Retrospective chart review. RESULTS All 3 patients had a background of chronic renal failure and presented to us with bilateral optic neuropathy (sequential in 2) and were found to have heteroplasmic m.13513G>A mutations in the MT-ND5 gene. Two of the patients were females (aged 30 and 45 years) with chronic kidney disease from their 20s, attributed to pre-eclampsia, one of whom also had diabetes and sudden bilateral hearing loss. One patient was a male (aged 54 years) with chronic kidney disease from his 20s attributed to IgA nephropathy. His mother had diabetes and apparently sudden bilateral blindness in her 70s. Renal biopsy findings were variable and included interstitial fibrosis, acute tubular necrosis, focal segmental glomerulosclerosis, and IgA/C3 tubular casts on immunofluorescence. Mild improvements in vision followed treatment with either idebenone or a combination supplement including coenzyme Q10, alpha-lipoic acid, and B vitamins. CONCLUSIONS Our cases expand the clinical syndromes associated with m.13513G>A to include bilateral optic neuropathy and adult-onset renal disease. This highlights that in patients with bilateral, especially sequential, optic neuropathy a broad approach to mitochondrial testing is more useful than a limited LHON panel. Mitochondrial diseases present a diagnostic challenge because of their clinical and genetic variability.
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Affiliation(s)
- Grace Swart
- Neurology Department (GS, GMH), Royal Prince Alfred Hospital, Sydney, Australia; Save Sight Institute (CLF), Faculty of Health and Medicine, University of Sydney, Sydney Australia; Pathology Department (MS), Westmead Hospital, Sydney, Australia; Radiology Department (EOT), Royal Prince Alfred Hospital, Sydney, Australia; Medical Genomics Department (AM), Royal Prince Alfred Hospital, Sydney, Australia; Ophthalmology Department (ML), Royal Prince Alfred Hospital, Sydney, Australia; Neurology Department (KA), Royal North Shore Hospital, Sydney, Australia; and Central Clinical School (GMH), Faculty of Health and Medicine, University of Sydney, Sydney, Australia
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3
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Momin RI, Baer SL, Waller JL, Young L, Tran S, Taskar V, Bollag WB. Atopic Dermatitis and the Risk of Infection in End-Stage Renal Disease. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2145. [PMID: 38138248 PMCID: PMC10744789 DOI: 10.3390/medicina59122145] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/24/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Atopic dermatitis (AD), also known as eczema, is a common chronic inflammatory skin condition affecting 16.5 million adults in the United States. AD is characterized by an impaired epidermal barrier that can predispose individuals to infection. End-stage renal disease (ESRD) is also commonly complicated by infections due to chronic vascular access and immune-system dysfunction, possibly related to uremia. Multiple studies have reported that renal disease is a common comorbidity in adults with atopic dermatitis. The aim of this study was to determine whether AD is a risk factor for certain infections in patients with ESRD. Materials and Methods: Using the United States Renal Data System, a retrospective cohort analysis was conducted on adult ESRD patients initiating dialysis between 2004 and 2019 to investigate associations between infections and AD in this population. Results: Of 1,526,266 patients, 2290 were identified with AD (0.2%). Infectious outcomes of interest were bacteremia, septicemia, cellulitis, herpes zoster, and conjunctivitis. In all infectious outcomes except for conjunctivitis, patients with the infectious outcomes were more likely to carry a diagnosis of AD. After controlling for demographic and clinical covariates, AD was associated with an increased risk of cellulitis (adjusted relative risk (aRR) = 1.39, 95% confidence interval (CI) = 1.31-1.47) and herpes zoster (aRR = 1.67, CI = 1.44-1.94), but not with bacteremia (aRR = 0.96, CI = 0.89-1.05), septicemia (aRR = 1.02, CI = 0.98-1.08), or conjunctivitis (aRR = 0.97, CI = 0.740-1.34). Conclusions: Overall, after controlling for demographic and clinical covariates and adjusting for person-years-at-risk, AD was associated with an increased risk for some, but not all, infections within the population of patients with ESRD.
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Affiliation(s)
- Rushan I. Momin
- Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (R.I.M.); (S.L.B.); (J.L.W.); (S.T.); (V.T.)
| | - Stephanie L. Baer
- Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (R.I.M.); (S.L.B.); (J.L.W.); (S.T.); (V.T.)
- Charlie Norwood Department, Veterans Affairs Medical Center, Augusta, GA 30904, USA
| | - Jennifer L. Waller
- Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (R.I.M.); (S.L.B.); (J.L.W.); (S.T.); (V.T.)
| | - Lufei Young
- School of Nursing at UNC Charlotte, University of North Carolina Charlotte, Charlotte, NC 28223, USA
| | - Sarah Tran
- Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (R.I.M.); (S.L.B.); (J.L.W.); (S.T.); (V.T.)
| | - Varsha Taskar
- Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (R.I.M.); (S.L.B.); (J.L.W.); (S.T.); (V.T.)
| | - Wendy B. Bollag
- Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (R.I.M.); (S.L.B.); (J.L.W.); (S.T.); (V.T.)
- Charlie Norwood Department, Veterans Affairs Medical Center, Augusta, GA 30904, USA
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Wen J, Liu D, Wu Q, Zhao L, Iao WC, Lin H. Retinal image‐based artificial intelligence in detecting and predicting kidney diseases: Current advances and future perspectives. VIEW 2023. [DOI: 10.1002/viw.20220070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Affiliation(s)
- Jingyi Wen
- State Key Laboratory of OphthalmologyZhongshan Ophthalmic CenterSun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Disease GuangzhouChina
| | - Dong Liu
- State Key Laboratory of OphthalmologyZhongshan Ophthalmic CenterSun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Disease GuangzhouChina
| | - Qianni Wu
- State Key Laboratory of OphthalmologyZhongshan Ophthalmic CenterSun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Disease GuangzhouChina
| | - Lanqin Zhao
- State Key Laboratory of OphthalmologyZhongshan Ophthalmic CenterSun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Disease GuangzhouChina
| | - Wai Cheng Iao
- State Key Laboratory of OphthalmologyZhongshan Ophthalmic CenterSun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Disease GuangzhouChina
| | - Haotian Lin
- State Key Laboratory of OphthalmologyZhongshan Ophthalmic CenterSun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Disease GuangzhouChina
- Center for Precision Medicine and Department of Genetics and Biomedical Informatics Zhongshan School of Medicine Sun Yat‐sen University Guangzhou China
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Shanti Y, Hamayel H, Yasin A, Shanab ARA, Hroub O, Hamdan Z, Shraim M. Epidemiology of Common Ocular Manifestations among Patients on Haemodialysis in West Bank, Palestine. Sultan Qaboos Univ Med J 2023; 23:61-67. [PMID: 36865416 PMCID: PMC9974027 DOI: 10.18295/squmj.4.2022.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/17/2022] [Accepted: 03/29/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives This study aimed to assess the prevalence of ocular manifestations and associated factors in patients on haemodialysis. Methods A cross-sectional study of patients on haemodialysis from a haemodialysis unit in Nablus, Palestine, was conducted. 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, ischaemic heart disease [IHD], peripheral arterial disease [PAD]) and use of antiplatelet or anti-coagulation medications. Results A total of 191 patients were included in this study. 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), proliferative diabetic retinopathy (PDR) and NPDR or PDR was 51%, 16% and 65%. Two patients had PDR in one eye and NPDR in the other, and therefore, they were counted only once making the total for this category 71 rather than 73 patients. An increase in age by one year increased 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 those with diabetes without IHD or PAD (OR = 7.62, 95% CI: 2.07-28.03). Conclusion Retinal changes and cataract are common ocular manifestations among patients on haemodialysis. The findings emphasise the importance of periodic screening for ocular problems in this vulnerable population, especially older patients and those with diabetes, to prevent visual impartment and associated disability.
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Affiliation(s)
- Yousef Shanti
- Department of Opthalmology, An-Najah National University Hospital, Nablus, Palestine
| | - Hamza Hamayel
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Anas Yasin
- Department of Opthalmology, An-Najah National University Hospital, Nablus, Palestine
| | | | - Osama Hroub
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Zakaria Hamdan
- Department of Nephrology, An-Najah National University Hospital, Nablus, Palestine
| | - Mujahed Shraim
- Department of Public Health, College of Health Sciences, Qatar University, QU Health, Doha, Qatar,Corresponding Author’s e-mail:
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Jayaraman D, Shivakumar M, Shanthaveerappa P. Ocular findings in patients with chronic kidney disease. TNOA JOURNAL OF OPHTHALMIC SCIENCE AND RESEARCH 2023. [DOI: 10.4103/tjosr.tjosr_39_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
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Kimura M, Toyoda M, Saito N, Abe M, Kato E, Sugihara A, Ishida N, Fukagawa M. A Survey on the Current Status of Ophthalmological Consultations in Patients With Diabetes Undergoing Maintenance Hemodialysis and the Effectiveness of Education on Consultation Behavior –Experience of a Single Hemodialysis Clinic in Japan. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 2:827718. [PMID: 36994342 PMCID: PMC10012105 DOI: 10.3389/fcdhc.2021.827718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/14/2021] [Indexed: 11/13/2022]
Abstract
IntroductionIt is extremely important for patients with diabetes undergoing maintenance hemodialysis (MHD) to receive regular ophthalmologic examinations. However, even in the field of MHD in Japan, where there are many hemodialysis patients and the survival rate is said to be one of the highest in the world, we often see patients with diabetes who do not receive regular ophthalmologic examinations. In this study, we surveyed the status of ophthalmology consultations and the use of diabetic eye notebook (DEN) among hemodialysis patients with diabetes at hemodialysis clinics to confirm the current situation, with the aim of confirming the effectiveness of education on consultation behavior by medical care staff.Materials and MethodsThis study included 38 diabetic hemodialysis patients attending one MHD clinic in Japan for one year from March 2018 to March 2019. In the first fact-finding survey in March 2018, hemodialysis care unit nurses (HCUNs) in the hemodialysis unit asked the diabetic hemodialysis patients whether they had consulted an ophthalmologist and used the DEN. Based on the results, the HCUNs recommended that hemodialysis patients with complications of diabetes be educated about the usefulness of regular ophthalmologic examinations, even during MHD, and that they use the DEN. This was followed by a second fact-finding survey in March 2019 to reconfirm ophthalmology consultations and DEN use.ResultsRegarding the presence of ophthalmology consultations, 22 of 38 (58%) patients had regular ophthalmology consultations in March 2018, and 27 of 38 (71%) patients had consultations in the following year after receiving information from an HCUN. Only 1 of 22 patients (5%) who consulted the ophthalmologist in March 2018 used a DEN, but 19 of 27 patients (70%) used it the following year.ConclusionIn the future, the development and utilization of a new DEN that includes more detailed patient information, and the spread of self-care guidance to patients by multidisciplinary health care professionals, will increase the consultation rate of MHD patients in Japan and reduce the incidence and progression of ocular diseases in MHD patients.
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Affiliation(s)
- Moritsugu Kimura
- Seichi Clinic, Isehara, Japan
- Division of Nephrology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan
- *Correspondence: Moritsugu Kimura,
| | - Masao Toyoda
- Seichi Clinic, Isehara, Japan
- Division of Nephrology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Nobumichi Saito
- Division of Nephrology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Makiko Abe
- Division of Nephrology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan
| | | | | | | | - Masafumi Fukagawa
- Division of Nephrology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan
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Babenko B, Mitani A, Traynis I, Kitade N, Singh P, Maa AY, Cuadros J, Corrado GS, Peng L, Webster DR, Varadarajan A, Hammel N, Liu Y. Detection of signs of disease in external photographs of the eyes via deep learning. Nat Biomed Eng 2022; 6:1370-1383. [PMID: 35352000 PMCID: PMC8963675 DOI: 10.1038/s41551-022-00867-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/15/2022] [Indexed: 01/14/2023]
Abstract
Retinal fundus photographs can be used to detect a range of retinal conditions. Here we show that deep-learning models trained instead on external photographs of the eyes can be used to detect diabetic retinopathy (DR), diabetic macular oedema and poor blood glucose control. We developed the models using eye photographs from 145,832 patients with diabetes from 301 DR screening sites and evaluated the models on four tasks and four validation datasets with a total of 48,644 patients from 198 additional screening sites. For all four tasks, the predictive performance of the deep-learning models was significantly higher than the performance of logistic regression models using self-reported demographic and medical history data, and the predictions generalized to patients with dilated pupils, to patients from a different DR screening programme and to a general eye care programme that included diabetics and non-diabetics. We also explored the use of the deep-learning models for the detection of elevated lipid levels. The utility of external eye photographs for the diagnosis and management of diseases should be further validated with images from different cameras and patient populations.
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Affiliation(s)
- Boris Babenko
- grid.420451.60000 0004 0635 6729Google Health, Palo Alto, CA USA
| | - Akinori Mitani
- grid.420451.60000 0004 0635 6729Google Health, Palo Alto, CA USA ,Artera, Mountain View, CA, USA
| | - Ilana Traynis
- Google Health via Advanced Clinical, Deerfield, IL USA
| | - Naho Kitade
- grid.420451.60000 0004 0635 6729Google Health, Palo Alto, CA USA
| | - Preeti Singh
- grid.420451.60000 0004 0635 6729Google Health, Palo Alto, CA USA
| | - April Y. Maa
- grid.189967.80000 0001 0941 6502Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA USA ,grid.484324.d0000 0004 0420 9995Regional Telehealth Services, Technology-based Eye Care Services (TECS) Division, Veterans Integrated Service Network (VISN) 7, Decatur, GA USA
| | | | - Greg S. Corrado
- grid.420451.60000 0004 0635 6729Google Health, Palo Alto, CA USA
| | - Lily Peng
- grid.420451.60000 0004 0635 6729Google Health, Palo Alto, CA USA
| | - Dale R. Webster
- grid.420451.60000 0004 0635 6729Google Health, Palo Alto, CA USA
| | | | - Naama Hammel
- grid.420451.60000 0004 0635 6729Google Health, Palo Alto, CA USA
| | - Yun Liu
- grid.420451.60000 0004 0635 6729Google Health, Palo Alto, CA USA
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Intraocular Pressure Changes during Hemodiafiltration with Two different Concentrations of Sodium in the Dialysate. BIOLOGY 2021; 11:biology11010012. [PMID: 35053010 PMCID: PMC8773306 DOI: 10.3390/biology11010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/23/2021] [Accepted: 12/18/2021] [Indexed: 11/28/2022]
Abstract
Simple Summary An increase in intraocular pressure during chronic hemodialysis is linked to ocular complications, such as glaucoma. The behavior of intraocular pressure during hemodiafiltration is unknown. Changes in intraocular pressure with a sodium dialysate concentration fixed at 138 mmol/L and an individualized concentration were studied in 13 patients with end-stage renal disease treated with hemodiafiltration. Up to 31% patients presented an episode of intraocular hypertension without differences between sodium profiles. A large variability in intraocular pressure within patients and a high prevalence of transient intraocular hypertension were found. Abstract Ocular complications are common among end-stage renal disease patients and some complications had been linked to increments of intraocular pressure (IOP) during hemodialysis. The changes of IOP during hemodiafiltration (HDF) have been scarcely investigated and the potential influence of the sodium dialysate concentration is unknown. The aim of this study was to compare the IOP changes during HDF with sodium dialysate concentration, either fixed or individualized. Thirteen end-stage renal disease patients participated in the study; they were treated with HDF using a dialysate sodium profile fixed at 138 mmol and another session with an individualized sodium profile. The intraocular pressure was measured before and after each session and every 30 min during HDF. Both groups had a similar HDF prescription, blood pressure, and biochemical parameters. At the end of hemodiafiltration, sodium concentration decreased only in the fixed sodium profile group. The number of patients with at least an episode of intraocular hypertension during HDF ranged from 5 (19%) to 8 (31%) without significant differences between right and left eye nor between dialysate sodium concentration. During HDF, there is a large variability of IOP; transient events of intraocular hypertension are highly prevalent in this sample, and they are not related to the sodium dialysate concentration.
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Hemodialysis Effect on the Composition of the Eye Fluid of Cataract Patients. J Clin Med 2021; 10:jcm10235485. [PMID: 34884186 PMCID: PMC8658160 DOI: 10.3390/jcm10235485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/13/2021] [Accepted: 11/20/2021] [Indexed: 11/27/2022] Open
Abstract
Numerous reports have proven that dialysis patients experience disturbances in the levels of elements in biological fluids. Disturbances in the homeostasis of essential elements or the appearance of highly toxic elements are serious problems also in clinical ophthalmology. The purpose of this study was to investigate the influence of hemodialysis (HD) on the elemental composition of anterior chamber aqueous humor (AH) in patients undergoing cataract surgery. The study involved 22 patients. The control group enrolled 16 patients (age 75.68 ± 9.67, female 54.55%, male 45.45%) with cataract and normal kidney function (control), and the second group included six patients (age 70.33 ± 12.74, female 33.33%, male 66.67%) with cataract undergoing HD treatment. The elements quantification was established using an inductively coupled plasma optical emission spectrometer (ICP-MS). In the eye fluid of dialysis patients, there were increased levels of manganese (Mn) and mercury (Hg) and decreased levels of vanadium (V) and zinc (Zn). In addition, a statistically significant increase in the Hg/Zn and Hg/selenium (Se) ratios and a lowering of the iron (Fe)/Mn ratio were observed in the studied group in comparison to the control. The obtained results indicated the need for Zn and Se supplementation in order to eliminate the hazards caused by Hg toxicity. A lower level of V in the eye fluid of dialysis patients may have a positive effect on maintaining a calcium and phosphorus homeostasis. Our study gives a deep insight into changes of elements concentrations in AH induced by HD.
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Almaznai A, Alsaud S, Fahmy R. Ocular parameters alterations after hemodialysis in patients with chronic kidney diseases. Saudi J Ophthalmol 2021; 35:9-14. [PMID: 34667926 PMCID: PMC8486027 DOI: 10.4103/1319-4534.325775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 12/01/2020] [Accepted: 12/06/2020] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To evaluate the effects of hemodialysis (HD) on visual acuity (VA), central corneal thickness (CCT), intraocular pressure (IOP), and macular thickness (MT) in chronic kidney disease (CKD) patients and also to investigate the relationship between the ocular parameters and blood biochemical parameters such as serum albumin, creatinine, sodium, and urea levels. METHODS A prospective cohort study including a total of 24 CKD patients of both genders (above 18 years old) undergoing HD in XXX was conducted. The participants were divided into three sub-groups based on the primary cause of renal failure, group 1: Hypertensive kidney disease, group 2: Diabetic kidney disease, group 3: Other causes. All subjects underwent full ophthalmological examinations including measurement of VA using LogMAR, IOP, CCT, and CMT. Comparisons between different ocular parameters during pre- and post-HD sessions were done using the paired t-test. The relationship between changes in ophthalmologic and blood biochemical parameters was calculated using Pearson correlation coefficient. RESULTS HD did not significantly alter any ocular parameter within and between CKD groups. Spherical equivalent changes were found to be significantly correlated with serum K (r = -0.315; P = 0.038), and IOP results were positively correlated with serum creatinine (r = 0.330; P = 0.029) and negatively correlated with hemoglobin (r = -0.349; P = 0.020). Bodyweight alterations were significantly correlated with CCT (r = -0.03; P = 0.0001). However, no correlation between ocular parameters and duration of HD was detected. CONCLUSION Following a single HD session, ocular parameters did not alter significantly.
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Affiliation(s)
- Abdullah Almaznai
- Department of Ophthalmology, King Saud Medical City, Riyadh, Saudi Arabia
| | - Sarah Alsaud
- Department of Optometry and Vision Sciences, College of Applied Medical Science, King Saud University, Riyadh, Saudi Arabia
| | - Rania Fahmy
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Lee WJ, Hong R, Kang MH, Cho H, Han SW, Yi JH, Shin YU, Seong M. Effect of Hemodialysis on Peripapillary Choroidal Thickness Measured by Swept-Source Optical Coherence Tomography. J Glaucoma 2021; 30:459-464. [PMID: 33337722 DOI: 10.1097/ijg.0000000000001762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 11/13/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim was to investigate the effects of hemodialysis (HD) on peripapillary choroidal thickness (PCT) by swept-source optical coherence tomography and on other ophthalmologic parameters in patients with end-stage kidney disease. MATERIALS AND METHODS This was a prospective observational study. The authors evaluated 29 patients who underwent HD for end-stage kidney disease. Detailed ophthalmologic examinations and swept-source optical coherence tomography were performed immediately before and after HD. PCT was measured using the modification tool in the built-in OCT image viewer program. Changes in PCT before and after HD were statistically analyzed. RESULTS The average PCT significantly decreased from 127.3±49.2 μm before HD to 117.1±50.9 μm after HD (P<0.001). A significant correlation was found between changes in PCT and macular choroidal thickness (ρ=0.547, P=0.002). Changes in mean ocular perfusion pressure did not significantly correlate with changes in PCT (ρ=-0.049, P=0.803). CONCLUSIONS PCT significantly decreased after HD. HD could influence the optic nerve head and its surrounding structures.
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Affiliation(s)
- Won June Lee
- Department of Ophthalmology
- Department of Ophthalmology, Hanyang University Seoul Hospital, Seoul
| | - Rimkyung Hong
- Department of Ophthalmology
- Department of Ophthalmology, Hanyang University Guri Hospital, Guri, Korea
| | - Min Ho Kang
- Department of Ophthalmology
- Department of Ophthalmology, Hanyang University Guri Hospital, Guri, Korea
| | - Heeyoon Cho
- Department of Ophthalmology
- Department of Ophthalmology, Hanyang University Guri Hospital, Guri, Korea
| | - Sang-Woong Han
- Internal Medicine, Division of Nephrology, Hanyang University College of Medicine
| | - Joo-Hark Yi
- Internal Medicine, Division of Nephrology, Hanyang University College of Medicine
| | - Yong Un Shin
- Department of Ophthalmology
- Department of Ophthalmology, Hanyang University Guri Hospital, Guri, Korea
| | - Mincheol Seong
- Department of Ophthalmology
- Department of Ophthalmology, Hanyang University Guri Hospital, Guri, Korea
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Mayali H, Altinisik M, Sarigul C, Toraman A, Turkoglu MS, Kurt E. Multimodal ocular evaluation in hemodialysis patients. Int Ophthalmol 2021; 41:1799-1805. [PMID: 33683498 DOI: 10.1007/s10792-021-01738-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate choroidal thickness, intraocular pressure (IOP), axial length, central corneal thickness (CCT), lens thickness, anterior chamber depth, and ocular pulse amplitude (OPA) in hemodialysis patients. MATERIALS AND METHODS The patients with end-stage renal disease and undergoing hemodialysis were included in the study. Immediately before and 1 hour after hemodialysis, all patients underwent measurement of choroidal thickness with spectral domain optical coherence tomography (SD-OC, Cirrus HD-OCT; Carl Zeiss Meditec Inc., Dublin, CA), IOP and OPA with Pascal dynamic contour tonometry (Ziemer Ophthalmic Systems AG, Port, Switzerland), and anterior chamber depth, lens thickness, and axial length with optical biometry (LenStar LS900; Haag-Streit AG, Koeniz, Switzerland). Data from the patients' right eyes were included in the statistical analysis. RESULTS The patient group included 8 (36.4%) males and 14 (63.6%) females with a mean age of 56, 14 ± 9, 96 (40-70) years. The mean subfoveal choroidal thickness before and after hemodialysis was 255.21 ± 6.15 (245-263) µm and 234.95 ± 7.89 (220-247) µm, respectively (p < 0.001). Mean choroidal thickness at 1500 µm and 3000 µm nasal and temporal of the fovea also decreased significantly after hemodialysis (p < 0.001). Mean OPA values before and after hemodialysis were 2.14 ± 1.07 (0.6-4) mmHg and 1.6 ± 0.86 (0.5-3.2) mmHg, respectively (p < 0.001). There was a statistically significant correlation between OPA and choroidal thickness measurements (p < 0.001, R = 0.923). IOP increased from 15.11 ± 2.58 (11-20) to 15.99 ± 2.21 (13-20) mmHg, but the change did not reach statistical significance (p = 0.05). There was no statistically significant change in mean axial length, anterior chamber depth, lens thickness, or CCT after hemodialysis (p > 0.05 for all). CONCLUSION Although choroidal thickness and OPA may be decreased immediately after hemodialysis, there may be no significant changes in IOP or avascular ocular structures such as the lens and cornea.
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Affiliation(s)
- Huseyin Mayali
- Ophthalmology Department, Medical School, Manisa Celal Bayar University, Manisa, Turkey.
| | - Muhammed Altinisik
- Ophthalmology Department, Medical School, Manisa Celal Bayar University, Manisa, Turkey
| | - Caglar Sarigul
- Ophthalmology Department, Medical School, Manisa Celal Bayar University, Manisa, Turkey
| | - Aysun Toraman
- Nephrology Department, Medical School, Manisa Celal Bayar University, Manisa, Turkey
| | - Mehmet Sirin Turkoglu
- Ophthalmology Department, Medical School, Manisa Celal Bayar University, Manisa, Turkey
| | - Emin Kurt
- Ophthalmology Department, Medical School, Manisa Celal Bayar University, Manisa, Turkey
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Carell EM. Case Report: Combined Ischemic Optic Neuropathy and Central Retinal Artery Occlusion after Starting Hemodialysis. Optom Vis Sci 2021; 98:212-216. [PMID: 33633019 DOI: 10.1097/opx.0000000000001655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE This case highlights ocular ischemia after hemodialysis resulting in permanent vision loss. Fifteen percent of the U.S. population suffers from chronic kidney disease. Eye care providers should recommend risk factor modifications to their patients with end-stage renal disease before hemodialysis is started to prevent loss of vision. PURPOSE The purpose of this study was to demonstrate a case of concurrent nonarteritic anterior ischemic optic neuropathy and central retinal artery occlusion in the setting of hemodialysis initiation. CASE REPORT A 68-year-old Irish man with end-stage renal disease undergoing dialysis presented, complaining of 3 weeks of progressive vision loss in his left eye. His medical history is complex and includes extensive cardiac disease, bilateral carotid stenosis, and peripheral vascular disease. His surgical history includes a right carotid endarterectomy, bilateral lower extremity amputations, and an aortic valve replacement. Clinical examination revealed light perception vision with an afferent pupillary defect in the left eye and count finger peripheral vision only in the superior temporal quadrant of his vision. The dilated fundus examination showed significant pallid disc edema and focal areas of retina whitening with attenuated peripapillary vasculature in the left eye. This edema was confirmed by optical coherence tomography and supported optic nerve and retinal infarction. A temporal artery biopsy confirmed no evidence of arteritis. CONCLUSIONS Hemodynamic disruption during dialysis in patients with end-stage renal disease and overlying anemia can result in optic nerve and retinal infarction. Patients who are predisposed to nonarteritic anterior ischemic optic neuropathy or central retinal artery occlusion should be educated on this before starting dialysis to ensure careful blood pressure monitoring.
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Shah R, Amador C, Tormanen K, Ghiam S, Saghizadeh M, Arumugaswami V, Kumar A, Kramerov AA, Ljubimov AV. Systemic diseases and the cornea. Exp Eye Res 2021; 204:108455. [PMID: 33485845 PMCID: PMC7946758 DOI: 10.1016/j.exer.2021.108455] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 01/08/2023]
Abstract
There is a number of systemic diseases affecting the cornea. These include endocrine disorders (diabetes, Graves' disease, Addison's disease, hyperparathyroidism), infections with viruses (SARS-CoV-2, herpes simplex, varicella zoster, HTLV-1, Epstein-Barr virus) and bacteria (tuberculosis, syphilis and Pseudomonas aeruginosa), autoimmune and inflammatory diseases (rheumatoid arthritis, Sjögren's syndrome, lupus erythematosus, gout, atopic and vernal keratoconjunctivitis, multiple sclerosis, granulomatosis with polyangiitis, sarcoidosis, Cogan's syndrome, immunobullous diseases), corneal deposit disorders (Wilson's disease, cystinosis, Fabry disease, Meretoja's syndrome, mucopolysaccharidosis, hyperlipoproteinemia), and genetic disorders (aniridia, Ehlers-Danlos syndromes, Marfan syndrome). Corneal manifestations often provide an insight to underlying systemic diseases and can act as the first indicator of an undiagnosed systemic condition. Routine eye exams can bring attention to potentially life-threatening illnesses. In this review, we provide a fairly detailed overview of the pathologic changes in the cornea described in various systemic diseases and also discuss underlying molecular mechanisms, as well as current and emerging treatments.
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Affiliation(s)
- Ruchi Shah
- Eye Program, Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Cynthia Amador
- Eye Program, Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Kati Tormanen
- Center for Neurobiology and Vaccine Development, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sean Ghiam
- Sackler School of Medicine, New York State/American Program of Tel Aviv University, Tel Aviv, Israel
| | - Mehrnoosh Saghizadeh
- Eye Program, Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Departments of Molecular and Medical Pharmacology, Medicine, and Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Vaithi Arumugaswami
- Departments of Molecular and Medical Pharmacology, Medicine, and Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Ashok Kumar
- Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University, Detroit, MI, USA
| | - Andrei A Kramerov
- Eye Program, Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alexander V Ljubimov
- Eye Program, Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Departments of Molecular and Medical Pharmacology, Medicine, and Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
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Kalayci M, Hassan IA, Keinan IA, Cetinkaya E, Suren E, Tahtabasi M, Sumbul HE. The Effect of Hemodialysis on Axial Length, Ocular Surface, and Intraocular Pressure in Patients with End-Stage Renal Failure. Int J Gen Med 2020; 13:1035-1042. [PMID: 33192087 PMCID: PMC7654548 DOI: 10.2147/ijgm.s281546] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 10/30/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the changes in intraocular pressure (IOP), central corneal thickness (CCT), axial length, and ocular surface in patients with end-stage renal failure after single-session hemodialysis treatment and to examine the correlation of these findings with systemic hemodynamic parameters. Patients and Methods A total of 112 eyes of 112 patients enrolled in a hemodialysis treatment program for three times a week (approximately four hours per session) for at least three months in our hospital between December 2019 and March 2020 were included in the study. Approximately 30 minutes before and after hemodialysis, the best-corrected visual acuity measurement, slit-lamp examination, IOP measurement, and dilated fundus examination with the Goldmann applanation tonometer were performed in all patients. The axial length measurement was undertaken by ultrasonic biometry, and the CCT measurement by ultrasonic pachymetry. The ocular surface evaluation was performed based on the tear breakup time (BUT), basal secretion time (BST) and keratoepitheliopathy score. Blood pressure, serum osmolarity, and body weight were measured before and after hemodialysis. Results The mean IOP decreased from 12.2 ± 3.5 to 10.8 ± 2.2 mmHg, and the mean decrease was 1.4 ± 2 mmHg, indicating statistical significance (p<0.001). The mean CCT dropped from 502 ± 41.2 to 494.1 ± 35.4 μm, and the mean decrease was 8.1 ± 7.7 μm, which also indicated a statistically significant change (p<0.001). The mean axial length was reduced from 23.1 ± 0.8 to 22.9 ± 0.8 mm. The reduction in the axial length was significant with an average value of 0.26 ± 0.15 mm (p<0.001). When the ocular surface changes were examined, BUT decreased from 7.4 ± 3.1 to 6.3 ± 2.5 s, BST from 8.6 ± 1.7 to 6.6 ± 1.3 mm, and the keratoepitheliopathy score increased from 0.36 ± 0.61 to 1.59 ± 0.93, and all these changes were statistically significant (p<0.001). There was a significant correlation between the axial length change and the IOP change (r=0.202, p=0.03). A significant correlation was also observed between BST and plasma colloid osmotic pressure (r=−0.268, p=0.004). In addition, there was a strong correlation between serum osmolarity and the keratoepitheliopathy score (r=−0.437, p<0.001). Conclusion Hemodialysis causes significant changes in IOP, CCT, axial length, and ocular surface. These changes should be considered in the ophthalmological examination of patients after the hemodialysis session.
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Affiliation(s)
- Mustafa Kalayci
- Department of Ophthalmology, Somalia Mogadishu-Turkey Education and Research Hospital, Mogadishu, Somalia.,Department of Ophthalmology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ibrahim Ali Hassan
- Department of Ophthalmology, Somalia Mogadishu-Turkey Education and Research Hospital, Mogadishu, Somalia
| | - Ibrahim Abdi Keinan
- Department of Ophthalmology, Somalia Mogadishu-Turkey Education and Research Hospital, Mogadishu, Somalia
| | - Ersan Cetinkaya
- Department of Ophthalmology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Elcin Suren
- Department of Ophthalmology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Mehmet Tahtabasi
- Department of Radiology, Somalia Mogadishu - Turkey Education and Research Hospital, Mogadishu, Somalia
| | - Hilmi Erdem Sumbul
- Department of Internal Medicine, Somalia Mogadishu-Turkey Education and Research Hospital, Mogadishu, Somalia
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Sravani NG, Mohamed A, Nandyala S, Chaurasia S. Outcomes of corneal transplantation using donor corneas retrieved from patients with chronic kidney disease. Indian J Ophthalmol 2020; 68:1054-1056. [PMID: 32461428 PMCID: PMC7508074 DOI: 10.4103/ijo.ijo_1465_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose: To report the outcomes of corneal transplantation utilizing corneas retrieved from donors with chronic kidney disease (CKD). Methods: Outcomes of corneal transplantation (optical PK and EK) performed from Jan 2018 to Dec 2018 utilizing donor corneas retrieved from CKD patients was performed retrospectively. Results: Of the total of 233 donor corneas retrieved from CKD, 135 (57.9%) were utilized for transplantation after the routine screening protocol of the eye bank. Mean age of the donors was 56.2 ± 13.5 years. The mean endothelial cell density on specular microscopy of the donor corneas used for optical PK was 2685.7 ± 377.6 cells/mm2 (range, 2028–3448 cells/mm2) and for EK was 2731.7 ± 189.1 cells/mm2 (range, 2380–3194 cells/mm2). The overall primary graft failure rate was 5.1%. All grafts except 1, cleared in the PK group. In the EK group (6 DMEK and 16 DSAEK), 1 patient had a complete graft detachment and another 1 had a primary graft failure after DMEK. Conclusion: The donor corneas retrieved from chronic kidney disease patients are safe and suitable for optical keratoplasty provided they meet the criteria for transplantation.
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Affiliation(s)
- N Geetha Sravani
- Ocular Biophysics, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Ashik Mohamed
- Ocular Biophysics, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sushma Nandyala
- Ocular Biophysics, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sunita Chaurasia
- Cornea and Anterior Segment Services, Ramayamma International Eye Bank, LV Prasad Eye Institute, Hyderabad, Telangana, India
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Sariyeva Ismayılov A, Aydin Guclu O, Erol HA. Ocular manifestations in hemodialysis patients and short-term changes in ophthalmologic findings. Ther Apher Dial 2020; 25:204-210. [PMID: 32400088 DOI: 10.1111/1744-9987.13510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/29/2020] [Accepted: 05/08/2020] [Indexed: 11/27/2022]
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.
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Affiliation(s)
| | - Ozge Aydin Guclu
- Department of Pulmonary Diseases, Boyabat 75th Year State Hospital, Sinop, Turkey
| | - Haşim Atakan Erol
- Department of Internal Medicine, Boyabat 75th Year State Hospital, Sinop, Turkey
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19
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Nusinovici S, Sabanayagam C, Teo BW, Tan GSW, Wong TY. Vision Impairment in CKD Patients: Epidemiology, Mechanisms, Differential Diagnoses, and Prevention. Am J Kidney Dis 2019; 73:846-857. [PMID: 30929852 DOI: 10.1053/j.ajkd.2018.12.047] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 12/31/2018] [Indexed: 11/11/2022]
Abstract
Eyes and kidneys have numerous structural, developmental, physiologic, and pathogenic pathways in common, suggesting that many kidney and eye diseases may be interlinked. Studies suggest that the prevalence of eye diseases and vision impairment are higher among persons with end-stage kidney disease and earlier stages of chronic kidney disease (CKD) than in those without. Ocular morbidity in persons with CKD and end-stage kidney disease may be due to the following risk factors: (1) underlying conditions and risk factors for CKD such as diabetes or hypertension, (2) metabolic disorders associated with CKD, (3) uremia and anemia, and (4) CKD treatment. Among the chief eye diseases, diabetic retinopathy and age-related macular degeneration are most consistently associated with CKD. Further research for eye diseases such as glaucoma and cataract is needed to determine their relationships with CKD. Despite the high prevalence and burden of vision impairment among persons with CKD, eye screening in patients with CKD is not currently recommended as standard practice. This review suggests that patients with CKD should be encouraged to undergo a complete eye examination. Furthermore, physicians should be aware that patients undergoing dialysis may develop acute eye problems such as acute glaucoma, and appropriate referral to ophthalmologists should be considered in those with a history of glaucoma or recent ocular surgery. Interdisciplinary collaboration between nephrologists and ophthalmologists will ensure enhanced and appropriate management of patients with CKD.
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Affiliation(s)
- Simon Nusinovici
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Boon Wee Teo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gavin Siew Wei Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore.
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20
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Shin YU, Lee DE, Kang MH, Seong M, Yi JH, Han SW, Cho H. Optical coherence tomography angiography analysis of changes in the retina and the choroid after haemodialysis. Sci Rep 2018; 8:17184. [PMID: 30464196 PMCID: PMC6249329 DOI: 10.1038/s41598-018-35562-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 11/02/2018] [Indexed: 12/14/2022] Open
Abstract
The purpose of this study is to evaluate the effect of haemodialysis on perfused vessel density, choroidal thickness (CT), and retinal thickness in end-stage renal disease (ESRD) using swept-source optical coherence tomography angiography (SS-OCTA). We studied twenty-nine eyes of 29 ESRD patients by ophthalmologic examination and SS-OCTA before and after haemodialysis. The colour-coded perfusion density maps were generated and perfused vessel density was calculated. Changes in systemic and other ocular parameters such as retinal and choroidal thickness were measured and analysed. Total perfused vessel density decreased significantly after haemodialysis in the choriocapillaris; it was not significantly different in the superficial capillary plexus (SCP) and the deep capillary plexus (DCP). Total CT decreased significantly, but total retinal thickness was not significantly different. There was no significant correlation between choriocapillaris perfused vessel density and CT. The reduction in choriocapillaris perfused vessel density correlated with the decrease in systolic and mean arterial blood pressures. The decrease in CT correlated with the ultrafiltration volume. There were no significant systemic and ocular factors affecting change in retinal thickness and perfused vessel density of SCP and DCP. This is the first study to assess the effect of haemodialysis on blood flow changes using SS-OCTA; changes may be more prominent in the choroidal compared to the retinal layer.
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Affiliation(s)
- Yong Un Shin
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
| | - Dong Eik Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Min Ho Kang
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
| | - Mincheol Seong
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
| | - Joo-Hark Yi
- Division of Nephrology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sang-Woong Han
- Division of Nephrology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Heeyoon Cho
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea.
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Chen H, Zhang X, Shen X. Ocular changes during hemodialysis in patients with end-stage renal disease. BMC Ophthalmol 2018; 18:208. [PMID: 30139333 PMCID: PMC6107936 DOI: 10.1186/s12886-018-0885-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 08/14/2018] [Indexed: 11/10/2022] Open
Abstract
Background To explore ocular changes during hemodialysis (HD) in chronic renal failure patients and to determine the effects of different causes of renal failure during HD. Methods A total of 90 eyes from 45 end-stage renal disease (ESRD) patients undergoing HD were evaluated in this study. All ophthalmological examinations were conducted within 1 h before and after a single HD session. The HD patients were divided into primary kidney disease (KD), hypertensive KD, diabetic KD (DM-KD) and unknown etiology subgroups according to the primary etiology of renal failure. The statistics of 38 eyes from 19 healthy people were set as normal control. Results Tear break-up time (TBUT) (P = 0.020), Schirmer’s I test results (P = 0.030), anterior chamber depth (ACD) (P = 0.006), lens thickness (LT) (P < 0.001) and choroidal thickness (CHT) (P < 0.001)decreased significantly after a single HD. The retinal nerve fiber layer (RNFL) thickness and average retinal thickness (RT) increased after HD, especially in the nasal inner macula (NIM) subfield (P < 0.001), the inferior inner macula (IIM) subfield (P = 0.004) and the superior outer macula (SOM) subfield (P = 0.012). TBUT, Schirmer’s I test, IOP, RT, and CHT were correlated with one or more parameters. All ESRD patients regardless of etiology had the same trend for most parameters during HD, with the exception of the logMAR of BCVA, central corneal thickness, RNFL thickness and CHT. Conclusions HD may affect a range of ocular parameters in ESRD patients. Dry eye parameters, RT and CHT exhibited the most obvious changes. Different etiologies tended to have similar trends in ocular parameter changes during HD.
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Affiliation(s)
- Hejun Chen
- Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 197 Rui Jin Er Road, Shanghai, 200025, China
| | - Xi Zhang
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.1665 Kongjiang Road, Shanghai, 200092, China
| | - Xi Shen
- Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 197 Rui Jin Er Road, Shanghai, 200025, China.
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Saavedra-Fuentes N, Pérez-Grovas H, Navarrete R, Lerma C. Intraocular Pressure Changes During Hemodialysis or Hemodiafiltration in End-Stage Renal Disease Patients. Ther Apher Dial 2018; 22:624-629. [PMID: 30009462 DOI: 10.1111/1744-9987.12707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 04/30/2018] [Accepted: 05/03/2018] [Indexed: 11/26/2022]
Abstract
The aim of this study was to evaluate the intraocular pressure during hemodialysis and hemodiafiltration. Fifteen patients were enrolled (seven treated with hemodialysis therapy and eight with hemodiafiltration). The intraocular pressure was measured before and after dialysis and every 30 min during dialysis. Before dialysis, both groups had similar dialysis prescription, blood pressure, and biochemical parameters. At the end of dialysis, potassium, and osmolarity decreased in both groups, while systolic blood pressure and sodium decreased in the hemodialysis group, and glucose decreased in the hemodiafiltration group. Mean intraocular pressure was similar between groups at all measured times and had no significant changes during hemodialysis. During minute 120 of hemodiafiltration, mean intraocular pressure in the left eye decreased significantly compared to minute 90. This suggests a high intra-individual variability of intraocular pressure during both types of dialysis, which could be relevant particularly among those with the risk of glaucoma.
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Affiliation(s)
- Nadia Saavedra-Fuentes
- Departamento de Nefrología, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Héctor Pérez-Grovas
- Departamento de Nefrología, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Ruth Navarrete
- Departamento de Glaucoma, Hospital Nuestra Señora de la Luz, Mexico City, Mexico
| | - Claudia Lerma
- Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
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Effect of Hemodialysis on Eye Coats, Axial Length, and Ocular Perfusion Pressure in Patients with Chronic Renal Failure. J Ophthalmol 2018; 2018:3105138. [PMID: 29576877 PMCID: PMC5822860 DOI: 10.1155/2018/3105138] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/14/2018] [Accepted: 01/16/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate changes in eye coats, axial length, and ocular perfusion pressure (OPP) in hemodialysis (HD) patients with chronic renal failure (CRF). Methods We included HD patients who were diagnosed with CRF in our hospital from January to December 2015. Fifty-two patients met the inclusion criteria; all right eyes were used for observation. Systolic and diastolic blood pressures were recorded to calculate OPP. Approximately 30 minutes before and after HD, we recorded multiple parameters, including lens thickness (LT), axial length of vitreous (VAL), axial length of eye (EAL), ciliary body thickness (CBT), choroidal thickness (CT), and retinal thickness (RT). Results After HD, OPP significantly decreased (P < 0.01, F = 7.023) and CBT became significantly thinner (P < 0.01, t = 3.461). CT was significantly thinner and differed among measurement locations (P < 0.01, t = 6.240; P < 0.01, t = 6.169; P < 0.01, t = 3.405, respectively, fovea, nasal, and temporal side 1500 μm beside the fovea). Further, RT thickened and differed among measurement locations (P < 0.05, t = −2.265; P < 0.05, t = −2.624; P < 0.05, t = −2.220, respectively, fovea, nasal, and temporal side 1500 μm beside fovea), whereas LT, VAL, and EAL significantly increased after HD (P < 0.05, t = −2.076; P < 0.01, t = −3.817; P < 0.01, t = −4.010). Conclusions HD impacts the thickness of the eye coats and VAL, particularly affecting CBT, CT, and RT. OPP transiently decreases during HD, which may contribute to an ischemic state.
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Su L, Huang G, Yin S, Hua X, Tang X. A clinical analysis of vitrectomy for severe vitreoretinopathy in patients with chronic renal. BMC Ophthalmol 2018; 18:34. [PMID: 29422012 PMCID: PMC5806368 DOI: 10.1186/s12886-018-0704-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 02/02/2018] [Indexed: 02/01/2023] Open
Abstract
Background The recent advancement in the management of chronic renal failure (CRF) has significantly increased the longevity of the patients, which increase the incidence of severe vitreoretinopathy. The vitrectomy is highly risky in this particular group of patients due to their systemic comorbidity. The timing surgical intervention is usually delayed because of the systemic conditions. This study is to evaluate the safety and effectiveness of 25-guage vitrectomy for severe vitreoretinopathy in the CRF patients. Methods In this retrospective study, 16 eyes of 16 CRF patients with severe vitreoretinopathy were undergone 25-guage vitrectomy in the department of Ophthalmology of the Second Hospital of Tianjin Medical University from February 2015 to April 2017. The visual outcome, complications and perioperative medical management were documented and analyzed. Results The best-corrected visual acuity(BCVA)of fourteen eyes were lower than 20/200 preoperatively. Surgery duration ranged from 28 to 72 min, with a mean of 48.4 ± 13.6 min. During the surgery, 12 eyes were diagnosed with DR, while two them were complicated with tractional retinal detachment and one with branch retinal vein occlusion. Three eyes were diagnosed with branch retinal vein occlusion, and one eye was diagnosed with hypertensive retinopathy. Postoperative BCVA of six eyes ≥20/40, seven eyes ≥20/200, and three eyes < 20/200. BCVA of eight eyes improved more than three lines, three eyes improved two lines, and four eyes improved one line. BCVA decreased from hand movement to light perception in one patient who developed neovascular glaucoma two weeks after surgery. Conclusion In chronic renal failure patients with severe vitreoretinopathy, the well-planned minimally invasive vitrectomy is effective and safe. Additionally, careful management of the perioperative systemic conditions is important to improve the visual acuity and quality of life as well.
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Affiliation(s)
- Long Su
- Department of Ophthalmology, The 2nd Hospital of Tianjin Medical University, Tianjin Institute of orbital Disease, Tianjin, China
| | - Guannan Huang
- Department of Ophthalmology, The 2nd Hospital of Tianjin Medical University, Tianjin Institute of orbital Disease, Tianjin, China
| | - Songtao Yin
- Department of Ophthalmology, The 2nd Hospital of Tianjin Medical University, Tianjin Institute of orbital Disease, Tianjin, China
| | - Xia Hua
- Department of Ophthalmology, The 2nd Hospital of Tianjin Medical University, Tianjin Institute of orbital Disease, Tianjin, China
| | - Xin Tang
- Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Vision Science Clinical College of Ophthalmology, Tianjin Medical University , No. 4 Gansu Rd, Heping District, Tianjin, 300020, China.
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Zhang Y, Weng H, Li Q, Wang Z. Changes in retina and choroid after haemodialysis assessed using optical coherence tomography angiography. Clin Exp Optom 2018; 101:674-679. [PMID: 29359351 DOI: 10.1111/cxo.12660] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 12/03/2017] [Accepted: 12/12/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Reports of choroidal and retinal changes before and after haemodialysis are few and have been controversial. Traditional imaging modalities are insufficient for quantitative assessment. This study aims to use optical coherence tomography angiography to monitor the short-term vascular density and thickness changes in retina and choroid before and after haemodialysis. METHODS Seventy-seven eyes of 77 patients with end-stage kidney disease undergoing haemodialysis were included. Ophthalmologic examinations including optical coherence tomography angiography were performed one hour before and after haemodialysis. The vascular density of retina and choroid were measured and calculated by optical coherence tomography angiography. The retinal thickness and subfoveal choroidal thickness were measured manually using Image J software. The relationships between the changes in ocular and systemic parameters after haemodialysis were evaluated. RESULTS The systolic blood pressure decreased from 123.7 ± 19.7 to 116.9 ± 24.6 mmHg (p < 0.05) in all patients. The mean ocular perfusion pressure decreased significantly after haemodialysis in both diabetic and non-diabetic groups (p < 0.05). Mean retinal thickness decreased from 204.7 ± 22.4 μm to 200.8 ± 22.8 μm (p < 0.05) after haemodialysis in all patients. The vascular density of outer retina was decreased from 38.8 ± 5.5 per cent to 37.5 ± 3.4 per cent (p < 0.05) after haemodialysis in all patients. The changes in diastolic blood pressure, intraocular pressure, subfoveal choroidal thickness, vascular density of the superficial capillary plexus, deep capillary plexus and choriocapillaris were insignificant. There was no significant correlation between systolic blood pressure and the vascular density of the outer retina. CONCLUSION In optical coherence tomography angiography, the retinal thickness became thinner and the vascular density in the outer retina decreased after haemodialysis in patients with end-stage kidney disease. The change of subfoveal choroidal thickness showed no significance after haemodialysis. The decreased volume in the retinal vascular bed and deficient choroidal autoregulatory control of ocular blood flow might be involved in the mechanism of these changes.
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Affiliation(s)
- Yu Zhang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, China
| | - Huan Weng
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qingjian Li
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhiliang Wang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, China
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Stamenković D, Vukša D, Đokić O, Mirković J, Mirković M, Jakšić V. Dry eye disease incidence in hemodialysis. PRAXIS MEDICA 2018. [DOI: 10.5937/pramed1804017s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Kal Ö, Ulusoy MO, Kal A, Tanriaşki G, Cezairlioğlu Ş. Evaluation of Dry Eye Using Anterior Segment Optical Coherence Tomography in Patients With End-Stage Renal Disease Undergoing Hemodialysis. Ther Apher Dial 2017; 22:104-108. [PMID: 29205873 DOI: 10.1111/1744-9987.12612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 08/08/2017] [Accepted: 08/16/2017] [Indexed: 11/28/2022]
Abstract
The aim of the present study was to evaluate dry eye parameters with conventional tests and tear meniscus with Anterior Segment Optical Coherence Tomography (AS-OCT) in patients with end-stage renal disease (ESRD). Thirty-eight ESRD patients undergoing hemodialysis, and 40 healthy individuals were enrolled. An ocular surface disease index questionnaire (OSDI) was administered. Before conventional dry eye tests, tear meniscus were evaluated using AS-OCT. After a complete ocular examination, Schirmer and break-up time (BUT) tests were performed and probable corneal staining was investigated. Schirmer test and BUT values were significantly lower in ESRD patients (P < 0.05). OSDI scores and corneal staining scores were significantly higher in ESRD patients (P < 0.05). Tear meniscus height, tear meniscus depth, and tear meniscus area, which were obtained by AS-OCT were significantly lower in patients with ESRD (P < 0.05). Tear meniscus evaluation using AS-OCT is an effective and non-invasive method to assess tear meniscus in patients with ESRD. Patients with ESRD undergoing hemodialysis should obtain regular ophthalmic examination, especially for dry eye.
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Affiliation(s)
- Öznur Kal
- Nephrology Department, Konya Research Hospital, Başkent University, School of Medicine, Konya, Turkey
| | - Mahmut Oğuz Ulusoy
- Ophthalmology Department, Konya Research Hospital, Başkent University, School of Medicine, Konya, Turkey
| | - Ali Kal
- Ophthalmology Department, Konya Research Hospital, Başkent University, School of Medicine, Konya, Turkey
| | - Gülşah Tanriaşki
- Ophthalmology Department, Başkent University, School of Medicine, Ankara, Turkey
| | - Şefik Cezairlioğlu
- Ophthalmology Department, Başkent University, School of Medicine, Ankara, Turkey
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Atilgan CU, Guven D, Akarsu OP, Sakaci T, Sendul SY, Baydar Y, Atilgan KG, Turker IC. Effects of hemodialysis on macular and retinal nerve fiber layer thicknesses in non-diabetic patients with end stage renal failure. Saudi Med J 2017; 37:641-7. [PMID: 27279510 PMCID: PMC4931645 DOI: 10.15537/smj.2016.6.13928] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To evaluate the thicknesses of retinal nerve fiber layer (RNFL) and macula by fourier-domain (FD) optical coherence tomography (OCT) in non-diabetic patients with end-stage-renal-failure (ESRF) undergoing hemodialysis (HD). METHODS This is a prospective and observational study. Both eyes of 20 patients receiving HD (group 1) and 34 control patients (group 2) were evaluated by FD-OCT. Macular and RNFL thicknesses were compared between groups and their correlation with age, duration of HD, and gender were examined. In group 1, macular and RNFL thicknesses were evaluated before and shortly after HD in the first day, first and sixth months. RESULTS In group 1, pre-HD temporal, inferior, average RNFL thicknesses were thinner than group 2. This thinning did not correlate with duration of HD, age and gender. Pre-HD macular thicknesses were thinner than group 2. These thinnings did not correlate with age, but the thinnings at superior, nasal and average thickness correlated negatively with duration of HD. Nasal, temporal, and average macular thicknesses were thinner in female patients. The thickenings of RNFL and macula that were observed in the after HD first day and first month did not showed consistency in the sixth month except superior quadrant RNFL. CONCLUSION Macular and RNFL thicknesses of patients receiving HD were less than the normal population. Age has no effect on these thinnings. The duration of HD affects more than gender. Hemodialysis session causes a consistent increase in superior quadrant RNFL.
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Affiliation(s)
- Cemile U Atilgan
- Department of Ophthalmology, Ulucanlar Eye Teaching and Research Hospital, Altindag, Ankara, Turkey. E-mail.
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Chang YS, Weng SF, Chang C, Wang JJ, Chen HI, Ko SY, Tu IT, Chien CC, Wang JJ, Wang CM, Jan RL. Risk of serous retinal detachment in patients with end-stage renal disease on dialysis. PLoS One 2017; 12:e0180133. [PMID: 28658289 PMCID: PMC5489197 DOI: 10.1371/journal.pone.0180133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 06/10/2017] [Indexed: 11/18/2022] Open
Abstract
The aim of this retrospective, nationwide, matched cohort study was to investigate the association of serous retinal detachment with having end-stage renal disease (ESRD) while on dialysis. The cohort study included 94,024 patients with ESRD on dialysis registered between January 2000 to December 2009 in the Taiwan National Health Insurance Research Database. An age- and sex-matched control group comprised 94,024 patients selected from the Taiwan Longitudinal Health Insurance Database 2000. Information for each patient was collected from the index date until December 2011. Twenty-seven ESRD patients and 11 controls developed serous retinal detachment (P < 0.001) during follow-up, demonstrating a significantly increased risk of serous retinal detachment in patients with ESRD on dialysis compared with controls (incidence rate ratio = 3.39, 95% confidence interval [CI] = 1.68–6.83). After adjustment for potential confounders, patients were 3.86 times more likely to develop serous retinal detachment than the full cohort (adjusted HR = 3.86, 95% CI = 1.15–12.96). In conclusion, patients with ESRD on dialysis demonstrate an increased risk of serous retinal detachment. Interdisciplinary collaboration between nephrologists and ophthalmologists is important to deal with serous retinal detachment in patients with ESRD on dialysis and prevent impairments of visual acuity.
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Affiliation(s)
- Yuh-Shin Chang
- Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan
- Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan, Taiwan
| | - Shih-Feng Weng
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun Chang
- Department of Education, University of Taipei, Taipei, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Hong-I Chen
- Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan, Taiwan
| | - Shun-Yao Ko
- Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan, Taiwan
| | - I-Te Tu
- Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Chih-Chiang Chien
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Jian-Jhong Wang
- Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Ching-Min Wang
- Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Ren-Long Jan
- Graduate Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pediatrics, Chi Mei Medical Center, Liouying, Tainan, Taiwan
- * E-mail:
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Jones DJW, Harris JP, Butler LT, Vaux EC. Stereopsis in end-stage renal disease (ESRD). Physiol Behav 2017; 171:1-6. [PMID: 28025091 DOI: 10.1016/j.physbeh.2016.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 12/02/2016] [Accepted: 12/21/2016] [Indexed: 11/17/2022]
Abstract
We investigated an effect of end-stage renal disease (ESRD) on the visual system by measuring the ability of 21 patients to perceive depth in the random dot stereograms and circles of the Randot Test. To control for other factors which might influence performance on the tests of stereopsis, patients were compared with healthy controls matched for age, years of education, IQ, and general cognitive ability. Vernier acuity (thought to reflect mainly central processing) and Landolt acuity (more sensitive to retinal and optical abnormalities) were also measured, but the study did not include a formal ophthalmological examination. All controls could perceive depth in random dot stereograms, whereas 9/21 patients could not. Patients who could perceive depth had worse stereoacuity than did their matched controls. The patient group as a whole had worse Vernier and Landolt acuities than the controls. The stereoblind patient subgroup had similar Vernier acuity to the stereoscopic subgroup, but worse Landolt acuity, and was more likely to have peripheral vascular disease. We conclude that ESRD had affected structures both within the eye, and within the visual brain. However, the similarity of Vernier acuity and difference of Landolt acuity in the stereoblind and stereoscopic patient subgroups suggest that the differences in stereoscopic ability arise from abnormalities in the eyes rather than in the brain.
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Affiliation(s)
- Daniel J W Jones
- School of Psychology and Clinical Language Sciences, University of Reading Malaysia, Malaysia.
| | - John P Harris
- School of Psychology and Clinical Language Sciences, University of Reading, UK
| | - Laurie T Butler
- School of Psychology and Clinical Language Sciences, University of Reading, UK
| | - Emma C Vaux
- Department of Renal Medicine, Royal Berkshire NHS Foundation Trust, UK
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Chiang WY, Lee JJ, Kuo HK, Chen YH, Chen CH, Chen YJ, Wu PC, Chen YW. Factors associated with corneal epithelial defects after pars plana vitrectomy. Int Ophthalmol 2017; 38:105-110. [PMID: 28050730 DOI: 10.1007/s10792-016-0429-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 12/26/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the risk factors associated with corneal epithelial defects (CED) and delayed healing (exceeding 1 week) following pars plana vitrectomy (PPV). METHODS This retrospective study enrolled patients who underwent PPV at a single center in Taiwan between 2011 and 2012. Medical records were reviewed, including demographic, underlying disease, surgical indication, operation parameters, and existence of CED. These data were statistically analyzed. All patients were evaluated during follow-ups at day 1 and week 1 after PPV. Patients with persistent CED 1 week after PPV were diagnosed with delayed healing. RESULTS A total of 255 patients were included in the study, consisting of 139 men and 116 women, with a mean age of 56.9 years. PPV was performed under the indications of rhegmatogenous retinal detachment (RRD), diabetic retinopathy, or vitreoretinal interface disease. Out of 255 eyes, 59 developed CED 1 day after surgery (23.1%), and CED was associated with younger age, diabetes mellitus (DM), RRD, longer duration of surgery, and silicon oil use during surgery. Among them, seven patients (11.9%) demonstrated delayed healing, which was associated with a higher rate of DM (p = 0.085), compared to patients who healed within 1 week. CONCLUSION Patients with RRD, longer duration of surgery, and DM may be at risk of developing CED after PPV. In addition, patients with DM demonstrated a higher incidence of delayed corneal healing.
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Affiliation(s)
- Wei-Yu Chiang
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, 83301, Taiwan
| | - Jong-Jer Lee
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, 83301, Taiwan
| | - Hsi-Kung Kuo
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, 83301, Taiwan
| | - Yi-Hao Chen
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, 83301, Taiwan
| | - Chih-Hsin Chen
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, 83301, Taiwan
| | - Yung-Jen Chen
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, 83301, Taiwan
| | - Pei-Chang Wu
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, 83301, Taiwan
| | - Yun-Wen Chen
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, 83301, Taiwan.
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Evaluation of the acute effect of haemodialysis on retina and optic nerve with optical coherence tomography. Saudi J Ophthalmol 2016; 30:233-235. [PMID: 28003781 PMCID: PMC5161809 DOI: 10.1016/j.sjopt.2016.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 10/31/2016] [Indexed: 11/21/2022] Open
Abstract
Purpose The primary objective of haemodialysis (HD) was to correct the composition and volume of body fluids. The aim of this study was to evaluate the acute effect of HD on mean arterial pressure changes and on retina and optic nerve with optical coherence tomography (OCT). Methods Fifty-three eyes of 28 patients were enrolled in this study. The patients’ retinal and RNFL thicknesses were measured by OCT and mean arterial pressure alterations were recorded before and immediately after HD session. Results The results show that while there was a reduction at central foveal thickness and ganglion cell layer thickness, central subfield and RNFL thickness were increased with HD session. But none of them were statistically significant (p = 0.320, p = 0.792, p = 0.744, p = 0.390). The mean arterial pressure of the patients decreased significantly (p < 0.05) but it was not correlated with retinal and RNFL values. Conclusion The changes in retinal and RNFL findings were not significant. But these alterations may effect the long term follow-up of the patients with retinal and optic nerve disease. Therefore it is important to pay attention HD session time for these patients’ measurements.
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Evaluation of Intraocular Pressure by Ocular Response Analyzer in Patients Undergoing Hemodialysis. J Glaucoma 2016; 25:e355-8. [PMID: 26734835 DOI: 10.1097/ijg.0000000000000364] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE The aim of this study was to compare the biomechanical parameters of the cornea and intraocular pressure (IOP) before and after hemodialysis (HD) in patients with end-stage renal disease (ESRD) and also healthy subjects. MATERIALS AND METHODS Twenty-one patients with ESRD undergoing HD treatment (study group) and 21 healthy individuals (control group) were enrolled in this prospective study. Right eyes of each subjects were included. Central corneal thickness (CCT) were measured using Sirius Scheimpflug camera. Corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated IOP (IOPcc), and Goldmann-related IOP (IOPg) were measured using ocular response analyzer. In the study group, measurements were taken just before HD and 30 minutes after HD. RESULTS The mean CCT, CRF, IOPg values did not differ between pre-HD, post-HD, and controls (P > 0.05). CH was found to be significantly higher in control group (10.6 ± 1.2 mm Hg) when compared with pre-HD (8.07 ± 1.8 mm Hg) and post-HD (8.8 ± 1.6 mm Hg) CH values (P = 0.0001). The mean IOPcc values did not differ pre-HD (18.5 ± 3.5 mm Hg) and post-HD (17.8 ± 3.9 mm Hg) (P = 0.39). The mean IOPcc values were lower significantly in control group (15.4 ± 2.8 mm Hg) when compared with pre-HD and post-HD values (P = 0.02 and 0.02, respectively). Significant correlations were seen between post-HD CRF and post-HD CCT (r = 0.6, P = 0.03); and post-HD IOPg and post-HD CCT (r = 0.51, P = 0.01). CONCLUSIONS ESRD may disrupt the biomechanical properties of the cornea. Changes in ocular response analyzer parameters should be kept in mind to evaluate accurate IOP measurements in patients with ESRD.
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Risk of Band Keratopathy in Patients with End-Stage Renal Disease. Sci Rep 2016; 6:28675. [PMID: 27346848 PMCID: PMC4921853 DOI: 10.1038/srep28675] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 06/06/2016] [Indexed: 11/08/2022] Open
Abstract
This study is a retrospective, nationwide, matched cohort study to investigate the risk of band keratopathy following end-stage renal disease (ESRD). The study cohort included 94,039 ESRD on-dialysis patients identified by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), code 585 and registered between January 2000 to December 2009 at the Taiwan National Health Insurance Research Database. An age- and sex-matched control group comprised 94,039 patients selected from the Taiwan Longitudinal Health Insurance Database 2000. Information for each patient was collected from the index date until December 2011. In total, 230 ESRD patients and 26 controls had band keratopathy (P < 0.0001) during the follow-up period, indicating a significantly elevated risk of band keratopathy in the ESRD patients compared with controls (incidence rate ratio = 12.21, 95% confidence interval [CI] = 8.14-18.32). After adjustment for potential confounders including sarcoidosis, hyperparathyroidism, iridocyclitis, and phthisis bulbi, ESRD patients were 11.56 times more likely to develop band keratopathy in the full cohort (adjusted HR = 11.56, 95% CI = 7.70-17.35). In conclusion, ESRD increases the risk of band keratopathy. Close interdisciplinary collaboration between nephrologists and ophthalmologists is important to deal with band keratopathy following ESRD and prevent visual acuity impairments.
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Patheja RS, Chidgey A. A rare case of bilateral cystoid macular oedema associated with decompensated Henoch-Schonlein purpura-related nephropathy. Clin Exp Ophthalmol 2016; 44:209-12. [DOI: 10.1111/ceo.12655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 09/09/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Rajan S Patheja
- Royal Brisbane and Women's Hospital; Brisbane Queensland Australia
| | - Aaron Chidgey
- Royal Brisbane and Women's Hospital; Brisbane Queensland Australia
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Anbar M, Ahmed ARH, El-Mazary AAM, Mahmoud RA. Ocular Surface Disorders in a Group of Egyptian Children with End Stage Renal Failure on Dialysis: A Cross-Sectional Study. J Ophthalmol 2016; 2016:4767819. [PMID: 26942000 PMCID: PMC4749802 DOI: 10.1155/2016/4767819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 01/04/2016] [Accepted: 01/04/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose. To investigate tear function, ocular manifestations, and squamous metaplasia of the conjunctival epithelium (SMCE) in children with end stage renal failure (ESRF) on dialysis. Methods. Thirty children with ESRF and 20 age and sex matched controls during the period from January 2014 to May 2015 underwent full ophthalmologic examination and the tear function was investigated by the Schirmer and tear film break-up time (TBUT) tests. SMCE was evaluated by impression cytology and immunocytochemistry. The correlations of tear function status with ESRF-related clinical and biochemical variables were measured statistically. Results. Dry eye symptoms were detected in 26% of children with ESRF, compared with none of the controls (P = 0.05) and SMCE was almost absent. Values of the Schirmer and TBUT tests were significantly lower in children with ESRF for right eye (t = 24.63, P = 0.01, and t = 11.9, P = 0.002, resp.) and left eye (t = 24.7, P = 0.02, and t = 11.4, P = 0.0004, resp.). TBUT and the Schirmer test values were correlated inversely with the duration of ESRF (R = -0.45, P = 0.01, and R = -0.46, P = 0.01, resp.) and with the duration of dialysis (R = -0.39, P = 0.03, and R = -0.45, P = 0.01, resp.). None of the following parameters was associated with distorted tear function including serum creatinine, electrolytes, parathyroid hormone, total protein, albumin, CBC parameters, and systolic or diastolic blood pressure. Conclusion. The basal tear secretion and tear film stability were lower while the dry eye symptoms such as itching and redness were more common among children with ESRF. The duration of ESRF and dialysis duration seem to be related to the disturbances in tear secretion and tear film stability. However, SMCE is very rare.
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Affiliation(s)
- Mohamed Anbar
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag 82524, Egypt
| | - Ahmed R. H. Ahmed
- Department of Pathology, Faculty of Medicine, Sohag University, Sohag 82524, Egypt
| | | | - Ramadan A. Mahmoud
- Department of Paediatrics, Faculty of Medicine, Sohag University, Sohag 82524, Egypt
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Çalışkan S, Çelikay O, Biçer T, Aylı MD, Gürdal C. Effect of hemodialysis on intraocular lens power calculation. Ren Fail 2015; 38:209-13. [DOI: 10.3109/0886022x.2015.1128235] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Twenty-four-hour intraocular pressure monitoring in normotensive patients undergoing chronic hemodialysis. Eur J Ophthalmol 2015; 26:24-9. [PMID: 26165324 DOI: 10.5301/ejo.5000651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate 24-hour intraocular pressure (IOP) changes caused by hemodialysis (HD). METHODS A prospective, observational, comparative 24-hour trial was performed on consecutive subjects with normal IOP undergoing maintenance HD 3 days a week between 13:00 and 17:00 hours in an academic setting. Following a comprehensive ocular assessment, those with conditions that may influence IOP were excluded and one eye was randomly selected. Twenty-four-hour IOP monitoring was performed on HD day 1 and then on a day without HD. The IOP was measured at 10:00, 13:00, 15:00, 17:00, 22:00, 02:00, and 06:00 employing Goldmann and Perkins tonometry on habitual position. During the course of 1 year, 18 patients completed the study. RESULTS Monitoring of IOP on HD day showed a significantly higher mean 24-hour IOP (15.4 ± 2.7 vs 14.1 ± 2.2 mm Hg; p = 0.025), higher mean peak 24-hour IOP (18.5 ± 3.5 vs 15.8 ± 2.5 mm Hg; p = 0.003), and wider 24-hour IOP fluctuation (6.2 ± 2.3 vs 4.0 ± 1.9 mm Hg; p = 0.001). When individual time points were compared, IOP was significantly higher at 17:00 on HD day, reflecting a gradual IOP elevation during HD (p = 0.021). Further, during the HD procedure (13:00-17:00), the mean IOP was significantly higher on a HD day (16.4 ± 3.0 vs 14.7 ± 2.4 mm Hg; p = 0.004). CONCLUSIONS This prospective, before/after trial suggests that HD significantly impacts 24-hour IOP characteristics in normotensive eyes. The long-term significance of these findings requires further elucidation in normotensive patients and, predominantly, in patients with glaucoma undergoing HD.
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Kang NH, Lee S, Jun RM. Comparison of epitheliotrophic factors in autologous serum eyedrops from sera of chronic renal failure patients vs. normal controls. Graefes Arch Clin Exp Ophthalmol 2015; 253:1705-12. [DOI: 10.1007/s00417-015-3056-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 05/08/2015] [Accepted: 05/11/2015] [Indexed: 10/23/2022] Open
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Purgert RJ, Peralta E, McClelland CM, Van Stavern GP. Combined anterior ischemic optic neuropathy and hemiretinal artery occlusion during hemodialysis. Can J Ophthalmol 2015; 50:e19-21. [PMID: 25677295 DOI: 10.1016/j.jcjo.2014.10.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 10/24/2014] [Accepted: 10/28/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Robert J Purgert
- School of Medicine, Washington University School of Medicine in St. Louis
| | | | - Collin M McClelland
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine in St. Louis, St. Louis, Mo
| | - Gregory P Van Stavern
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine in St. Louis, St. Louis, Mo..
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Chelala E, Dirani A, Fadlallah A, Slim E, Abdelmassih Y, Fakhoury H, Baz P, Bejjani R. Effect of hemodialysis on visual acuity, intraocular pressure, and macular thickness in patients with chronic kidney disease. Clin Ophthalmol 2015; 9:109-14. [PMID: 25657575 PMCID: PMC4295916 DOI: 10.2147/opth.s74481] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the effects of hemodialysis (HD) on visual acuity, intraocular pressure (IOP), and central foveal thickness (CFT) in patients with chronic kidney disease. MATERIALS AND METHODS Forty-nine eyes from 49 chronic kidney-disease patients were analyzed. Causes of chronic kidney disease included diabetes mellitus (n=9 patients), hypertensive nephrosclerosis (n=15 patients), and other causes (n=25 patients). All patients underwent HD in the Dialysis Unit of Hôtel-Dieu de France Hospital. Best-corrected visual acuity, CFT, and IOP were evaluated before and after HD. CFT was measured with spectral domain optical coherence tomography, and IOP was measured with Goldmann applanation tonometry. RESULTS Neither decimal best-corrected visual acuity (pre-HD 0.71±0.32, post-HD 0.72±0.31; P=0.877) nor CFT (pre-HD 251.39±39.29, post-HD 253.09±39.26; P=0.272) significantly changed after HD. However, mean IOP significantly decreased from 13.99±2.48 before HD to 12.65±2.41 mmHg after HD (P=0.001). IOP change was significantly correlated with serum albumin levels (P=0.008) and weight changes (P=0.047). CONCLUSION HD can affect various ocular parameters. This is particularly true of IOP, which decreases significantly following HD.
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Affiliation(s)
- Elias Chelala
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon
| | - Ali Dirani
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon
| | - Ali Fadlallah
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon
| | - Elise Slim
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon
| | - Youssef Abdelmassih
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon
| | | | - Patrick Baz
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon
| | - Riad Bejjani
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon
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Ulaş F, Doğan Ü, Keleş A, Ertilav M, Tekçe H, Celebi S. Evaluation of choroidal and retinal thickness measurements using optical coherence tomography in non-diabetic haemodialysis patients. Int Ophthalmol 2013; 33:533-9. [PMID: 23456509 DOI: 10.1007/s10792-013-9740-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 02/07/2013] [Indexed: 11/29/2022]
Abstract
The aim of this study is to evaluate the effects of haemodialysis with a high ultrafiltration rate on the choroidal and retinal thickness of non-diabetic end-stage chronic renal failure (CRF) patients using optical coherence tomography (OCT). Twenty-one eyes of 21 male CRF patients aged between 46 and 80 years were included in this prospective study. Retinal and choroidal thicknesses of the patients were measured using high-resolution OCT line scans with the activated enhanced depth imaging mode before and shortly after haemodialysis. Retinal and choroidal thickness measurements were taken at the fovea and at two points that were 1,500 μm nasal and temporal to the fovea. The relationships between the haemodynamic changes, intraocular pressure (IOP) and central corneal thickness (CCT) were also evaluated. The mean choroidal thicknesses before haemodialysis at the subfoveal, temporal and nasal locations were 232.81 ± 71.92, 212.43 ± 70.50 and 182.14 ± 68.88 μm, respectively. The mean choroidal thicknesses after haemodialysis at the subfoveal, temporal and nasal locations were 210.90 ± 65.53, 195.38 ± 66.48 and 165.19 ± 66.73 μm, respectively. There were significant differences between the choroidal thicknesses before and after haemodialysis (p < 0.001 for all). The mean retinal thicknesses before haemodialysis at the foveal, temporal and nasal locations were 215.86 ± 41.06, 308.86 ± 37.73 and 338.00 ± 33.32 μm, respectively. The mean retinal thicknesses after haemodialysis at the foveal, temporal and nasal locations were 216.90 ± 39.70, 313.86 ± 32.89 and 335.29 ± 36.85 μm, respectively. There was no significant difference between the retinal thicknesses before and after haemodialysis (p > 0.05 for all). The mean CCT decreased insignificantly from 550.48 ± 17.46 to 548.10 ± 21.12 μm (p = 0.411). The mean IOP decreased significantly from 14.09 ± 2.58 to 12.54 ± 2.23 mmHg (p = 0.003), which did not correlate with the CCT [r = (-)0.134, p = 0.562]. Haemodialysis with a high ultrafiltration volume did not alter the retinal thickness but caused a significant choroidal thinning and an IOP decrease in non-diabetic end-stage CRF patients.
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Affiliation(s)
- Fatih Ulaş
- Department of Ophthalmology, Abant Izzet Baysal University of Medicine, Bolu, Turkey,
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