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Effect of hemodialysis (HD) on intraocular pressure, ocular surface, and macular change in patients with chronic renal failure

Effect of hemodialysis on the ophthalmologic findings

  • Medical Ophthalmology
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

The main objective of hemodialysis (HD) is to correct the excessive accumulation and abnormal distribution of body fluid. Therefore, changes in the systemic hemodynamic parameters and in the ocular fluid volume and composition can occur during a single HD session. The aim of this study is to evaluate the short-term changes in the ophthalmologic findings after HD.

Methods

Thirty eyes of 30 patients with chronic renal failure (CRF) undergoing HD were analyzed. The subjects were categorized into two groups according to the cause of CRF. Detailed ophthalmologic examinations were performed immediately before and after HD. The relationships between the systemic hemodynamic changes and the ophthalmologic changes during a single HD session were evaluated.

Results

The results show that a body fluid correction after HD involves a change in the plasma colloid osmotic pressure. The mean intraocular pressure (IOP) decreased after HD with a mean decrease of 2.4 ± 2.1 mmHg and the central corneal thickness decreased with a mean change of 6.9 ± 5.4 μm. After HD, the ocular surface changed significantly; the tear break-up time (TBUT) and basal tear secretion (Schirmer's test) decreased, whereas the keratoepitheliopathy score increased. The macular thickness measured by spectral domain optical coherence tomography (SD-OCT) decreased after HD. The mean decrease in the central subfield thickness was 7.4 ± 9.9 μm. The ocular surface changes after HD affected the visual acuity and examination quality. A significant correlation was found between the changes in the systemic hemodynamic parameters and those in the ophthalmologic findings, except for the retinal thickness.

Conclusions

The changes in the ophthalmologic findings after HD were consistent and significant in all CRF subjects. These changes correlated with the increase in plasma colloid osmotic pressure. HD can correct the volume and composition of ocular fluid. Therefore, it can affect the ophthalmologic findings in a short period of time. In addition, for good examination quality, it is recommended that an ophthalmologic examination in CRF patients be performed on a non-dialysis day or prior to HD on a dialysis day. Furthermore, for accurate comparison of examination results, the time interval from an HD session to an ophthalmologic examination must be considered.

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Acknowledgments

This study was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MEST) (No. 2010-0012245) and by the Converging Research Center Program funded by the Ministry of Education, Science and Technology (2011K000697)

Financial support

None.

Conflict of interest

The authors have no proprietary interest in the material used in this study.

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Authors and Affiliations

  1. Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea

    Ji Won Jung, Myung Hun Yoon & Hee Seung Chin

  2. Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea

    Seoung Woo Lee

  3. Department of Ophthalmology, Inha University Hospital, 7-206 Shinheung-Dong, Jung-Gu, Incheon, Korea, 400-711

    Hee Seung Chin

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  1. Ji Won Jung
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  2. Myung Hun Yoon
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Correspondence to Hee Seung Chin.

Additional information

The authors have full control of all primary data and agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review the data if requested.

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Jung, J.W., Yoon, M.H., Lee, S.W. et al. Effect of hemodialysis (HD) on intraocular pressure, ocular surface, and macular change in patients with chronic renal failure. Graefes Arch Clin Exp Ophthalmol 251, 153–162 (2013). https://doi.org/10.1007/s00417-012-2032-6

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  • DOI: https://doi.org/10.1007/s00417-012-2032-6

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