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Acquired night blindness due to rod dysfunction after long-term hemodialysis

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To report the clinical findings in 6 patients who developed night blindness after long-term hemodialysis.

Study design

Retrospective case series.

Patients and methods

The medical charts of the 6 patients were examined. The fundus photographs, spectral-domain optical coherence tomographic (SD-OCT) images, full-field ERGs, and blood chemistry panels were analyzed.

Results

The mean age of the 6 patients (4 men) at the time of diagnosis was 69.1 ± 5.9 years. The mean duration of the hemodialysis was 21.8 ± 13.4 years (7–41 years). The visual acuity of the patients was preserved at 20/30 or better except in 1 eye. Ophthalmoscopy showed white flecks that were scattered over the midperipheral retina in all the eyes. SD-OCT showed mild macular degeneration in 5 eyes. The scotopic ERGs elicited by dim flashes were absent, and those elicited by bright flashes had negative waveforms. The photopic ERGs were relatively well preserved. These data indicated a rod-specific dysfunction that may account for the night blindness. The plasma concentration of vitamin A was within the normal range in 4 of the patients and slightly lower than the normal limit in 1 of the patients. Administration of vitamin A was performed for 1 patient, and the symptom of night blindness and scotopic ERGs were improved 3 months later.

Discussion

Long-term hemodialysis can be associated with the night blindness that may be caused by vitamin A deficiency, even though the plasma concentration of vitamin A in these patients was within the normal range.

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Acknowledgements

We thank Professor Emeritus Duco Hamasaki (Bascom Palmer Eye Institute) for discussions and for editing the final version of the manuscript. This work was supported by the Japan Society for the Promotion of Science (JSPS) Kakenhi grant numbers 19K09928 (to S.U.).

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Authors and Affiliations

  1. Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan

    Shinji Ueno & Satoshi Okado

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  1. Shinji Ueno
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Correspondence to Shinji Ueno.

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S. Ueno, None; S. Okado, None.

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Corresponding Author: Shinji Ueno

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Ueno, S., Okado, S. Acquired night blindness due to rod dysfunction after long-term hemodialysis. Jpn J Ophthalmol 66, 1–7 (2022). https://doi.org/10.1007/s10384-021-00883-z

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  • DOI: https://doi.org/10.1007/s10384-021-00883-z

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