Abstract
Purpose: :
To compare the intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness and central corneal thickness (CCT) in healthy individuals and patients with chronic renal failure (CRF) undergoing hemodialysis, and to evaluate the changes of each parameters before and after hemodialysis in patients with CRF.
Methods: :
Thirty-six eyes of 36 patients with CRF undergoing hemodialysis were included to the hemodialysis group and 54 eyes of 54 healthy subjects were recruited as a control group. Eyes with glaucoma or diabetic retinopathy were excluded. All subjects underwent complete eye examination, including best-corrected visual acuity (BCVA), slit lamp examination, dilated funduscopic examination, gonioscopy, automated perimetry, IOP measurement using Goldman applanation tonometry, corneal pachymetry, and evaluation of RNFL thickness with optical coherence tomography. The serum osmolarity, body weight, and serum creatinine level were measured in CRF patients before hemodialysis. In hemodialysis group, IOP, RNFL thickness, CCT, serum osmolarity, and body weight were measured again within 1 hour after hemodialysis.
Results: :
Age, sex, BCVA, cup-to-disc ratio, IOP, and CCT were not statistically different between the two groups. The RNFL of hemodialysis group was statistically significantly thinner that of the control group (p<0.001). In patients with hemodialysis, the mean reduction in serum osmolarity and body weight after hemodialysis were 16.88±6.62 mOsm/Kg (p<0.001) and 2.57±1.56Kg (p<0.001), respectively. The IOP decreased from 16.52 ± 2.95 mmHg to 14.88 ± 2.03 mmHg after hemodialysis (1.63 ± 3.27 mmHg; p=0.005). The changes of RNFL thickness and CCT were not statistically significant (p=0.148, p=0.352).
Conclusions: :
In CRF patients with hemodialysis, RNFLs were thinner than those of the control group and hemodialysis induced significant IOP reduction. These findings should be considered for the proper evaluation of ocular disorders in CRF patients with hemodialysis.
Keywords: intraocular pressure • nerve fiber layer • cornea: clinical science