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Lior Lipsky, Oriel Spierer, Nur Azem, Meital Shaked, Meira Neudorfer; The influence of hemodialysis treatment on retinal thickness and macular edema in patients with diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2436.
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End stage renal disease patients treated with hemodialysis have higher incidence of diabetic retinopathy. Optical coherence tomography (OCT) is considered the gold standard for evaluating and quantifying macular edema. The purpose of this study is to evaluate the change in retinal thickness and macular edema using OCT, in patients with diabetic retinopathy undergoing hemodialysis.
A non-randomized prospective study was conducted. Twenty-three diabetic retinopathy patients (40 eyes) treated with hemodialysis at the Tel Aviv Medical Center were included. Patients underwent a comprehensive ophthalmic examination. In addition, OCT examination was preformed 30 minutes before, and 30 minutes after hemodialysis, documenting retinal thickness changes. Other variables including albumin levels, hemoglobin A1C levels, blood pressure and patient's weight were documented.
Among patients with macular edema (19 eyes) mean change in macular thickness at the fovea was -7.8 microns (p=0.4) in the right eye and -23.1 microns (p=0.4) in the left eye. Among patients without macular edema (21 eyes) mean change in macular thickness at the fovea was 3.7 micron (p=0.4) in the right eye and -1.0 microns (p=0.5) in the left eye. Measuring macular thickness change at the perifoveal and extrafoveal areas did not reveal significant results in subjects with or without macular edema. No difference between males and females regarding retinal thickness change after hemodialysis treatment was encountered. No correlation was found between retinal thickness change and albumin levels, hemoglobin A1C levels, weight difference before and after hemodialysis and blood pressure difference before and after hemodialysis.
Hemodialysis causes a small, non significant, reduction in macular thickness among patients with diabetic macular edema. Hemodialysis in subjects with diabetic retinopathy but without macular edema does not influence retinal thickness.
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