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The effect of hemodialysis on individual retinal layer thickness

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Abstract

Purpose

The aim of this study was to employ newly developed advanced image analysis software to evaluate changes in retinal layer thickness following hemodialysis.

Methods

A non-randomized prospective study of patients with end-stage renal disease assessed on the same day before and after hemodialysis. Intraocular pressure and central corneal thickness were analyzed, and spectral domain optical coherence tomography results were automatically segmented using the Orion software and then compared. All patients had normal retinal optical coherence tomography findings before hemodialysis.

Results

Of the 31 suitable end-stage renal disease patients treated with hemodialysis who provided consent to participate, seven were unable to complete all evaluations, leaving 24 patients for analysis in the final study group. Their mean age was 66.67±14.3 years (range: 35-88), and 62.5% were males. Mean central corneal thickness did not change following hemodialysis (563.4±30.2 µm to 553.1±47.2 µm, p=.247), while mean intraocular pressure decreased (14.48±2.5 mmHg to 13.16±2.28 mmHg, p=.028). Individual mean retinal layer thickness showed no significant change, including the retinal nerve fiber layer (40.9±6.8 µm to 40.1±5.2 µm, p=.412), the ganglion cell and the inner plexiform layer (68.66±8 µm to 69.03±7.6 µm, p=.639), and the photoreceptor layer (50.26±2.8 µm to 50.32±3.1 µm, p=.869). Total retinal thickness similarly remained constant, with a mean of 303.7±17.3 µm before and 304.33±18.4 µm after hemodialysis (p=.571).

Conclusions

Thickness of retinal layers, as assessed by individual segmentation, and central corneal thickness were not affected by hemodialysis treatment, while intraocular pressure was significantly reduced among patients with end-stage renal disease without pre-existing ocular pathology who were undergoing hemodialysis. These results support the view that hemodialysis does not have a negative impact on the retinal morphology of end-stage renal disease patients, who comprise a population with high rates of diabetic and/or hypertensive retinopathy as well as vision-threatening complications.

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Data availability

All data and material are available upon reasonable request from the corresponding author.

References

  1. Cheung N, Mitchell P, Wong TY (2010) Diabetic retinopathy. Lancet 376(9735):124–136. https://doi.org/10.1016/S0140-6736(09)62124-3

    Article  PubMed  Google Scholar 

  2. Tancredi M, Rosengren A, Svensson AM, Kosiborod M, Pivodic A, Gudbjornsdottir S, Wedel H, Clements M, Dahlqvist S, Lind M (2015) Excess mortality among persons with type 2 diabetes. New Engl J Med 373(18):1720–1732. https://doi.org/10.1056/NEJMoa1504347

    Article  CAS  PubMed  Google Scholar 

  3. Theodossiadis PG, Theodoropoulou S, Neamonitou G, Grigoropoulos V, Liarakos V, Triantou E, Theodossiadis GP, Vlahakos DV (2012) Hemodialysis-induced alterations in macular thickness measured by optical coherence tomography in diabetic patients with end-stage renal disease. Ophthalmol J Int d’ophtalmol Int J Ophthalmol 227(2):90–94. https://doi.org/10.1159/000331321

    Article  Google Scholar 

  4. Pahor D, Gracner B, Gracner T, Hojs R (2008) Optical coherence tomography findings in hemodialysis patients. Klin Monbl Augenheilkd 225(8):713–717. https://doi.org/10.1055/s-2007-963761

    Article  CAS  PubMed  Google Scholar 

  5. Perkovich BT, Meyers SM (1988) Systemic factors affecting diabetic macular edema. Am J Ophthalmol 105(2):211–212

    Article  CAS  Google Scholar 

  6. Bresnick GH (1983) Diabetic maculopathy. A critical review highlighting diffuse macular edema. Ophthalmology 90 (11):1301–1317

  7. Jung JW, Yoon MH, Lee SW, Chin HS (2013) 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. Graefes Arch Clin Exp Ophthalmol 251(1):153–162. https://doi.org/10.1007/s00417-012-2032-6

    Article  PubMed  Google Scholar 

  8. Emre S, Ozturkeri A, Ulusoy MO, Cankurtaran C (2016) Evaluation of the acute effect of haemodialysis on retina and optic nerve with optical coherence tomography. Saudi J Ophthalmol 30(4):233–235. https://doi.org/10.1016/j.sjopt.2016.10.007

    Article  PubMed  PubMed Central  Google Scholar 

  9. Azem N, Spierer O, Shaked M, Neudorfer M (2014) Effect of hemodialysis on retinal thickness in patients with diabetic retinopathy, with and without macular edema. Using Optical Coherence Tomography J Ophthalmol 2014:709862. https://doi.org/10.1155/2014/709862

    Article  PubMed  Google Scholar 

  10. Kal A, Kal O, Eroglu FC, Oner O, Kucukerdonmez C, Yilmaz G (2016) Evaluation of choroidal and retinal thickness measurements in adult hemodialysis patients using spectral-domain optical coherence tomography. Arq Bras Oftalmol 79(4):229–232. https://doi.org/10.5935/0004-2749.20160066

    Article  PubMed  Google Scholar 

  11. Chen H, Zhang X, Shen X (2018) Ocular changes during hemodialysis in patients with end-stage renal disease. BMC Ophthalmol 18(1):208. https://doi.org/10.1186/s12886-018-0885-0

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Gronenschild EH, Habets P, Jacobs HI, Mengelers R, Rozendaal N, van Os J, Marcelis M (2012) The effects of freesurfer version, workstation type, and Macintosh operating system version on anatomical volume and cortical thickness measurements. PLoS ONE 7(6):e38234. https://doi.org/10.1371/journal.pone.0038234

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Keller J, Oakley JD, Russakoff DB, Andorra-Ingles M, Villoslada P, Sanchez-Dalmau BF (2016) Changes in macular layers in the early course of non-arteritic ischaemic optic neuropathy. Graefe’s Arch Clin Exp Ophthalmol 254(3):561–567. https://doi.org/10.1007/s00417-015-3066-3

    Article  Google Scholar 

  14. Hecht I, Yeshurun I, Bartov E, Bar A, Burgansky-Eliash Z, Achiron A (2018) Retinal layers thickness changes following epiretinal membrane surgery. Eye (Lond) 32(3):555–562

    Article  CAS  Google Scholar 

  15. Daugirdas JT, Depner TA, Inrig J, Mehrotra R, Rocco MV, Suri RS, Weiner DE, Greer N, Ishani A, MacDonald R, Olson C, Rutks I, Slinin Y, Wilt TJ, Rocco M, Kramer H, Choi MJ, Samaniego-Picota M, Scheel PJ, Willis K, Joseph J, Brereton L (2015) KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update. Am J Kidney Dis 66(5):884–930. https://doi.org/10.1053/j.ajkd.2015.07.015

    Article  Google Scholar 

  16. Karakosta A, Vassilaki M, Plainis S, Elfadl NH, Tsilimbaris M, Moschandreas J (2012) Choice of analytic approach for eye-specific outcomes: one eye or two? Am J Ophthalmol 153(3):571-579.e571

    Article  Google Scholar 

  17. Tan J, Yang Y, Jiang H, Liu C, Deng Z, Lam BL, Hu L, Oakley J, Wang J (2016) The measurement repeatability using different partition methods of intraretinal tomographic thickness maps in healthy human subjects. Clin Ophthalmol 10:2403–2415. https://doi.org/10.2147/OPTH.S117494

    Article  PubMed  PubMed Central  Google Scholar 

  18. Seigo MA, Sotirchos ES, Newsome S, Babiarz A, Eckstein C, Ford E, Oakley JD, Syc SB, Frohman TC, Ratchford JN, Balcer LJ, Frohman EM, Calabresi PA, Saidha S (2012) In vivo assessment of retinal neuronal layers in multiple sclerosis with manual and automated optical coherence tomography segmentation techniques. J Neurol 259(10):2119–2130. https://doi.org/10.1007/s00415-012-6466-x

    Article  PubMed  Google Scholar 

  19. Hammes HP, Welp R, Kempe HP, Wagner C, Siegel E, Holl RW, Mellitus DPVI-GBCND (2015) Risk factors for retinopathy and dme in type 2 diabetes-results from the german/austrian dpv database. PLoS ONE 10(7):e0132492. https://doi.org/10.1371/journal.pone.0132492

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Boelter MC, Gross JL, Canani LH, Costa LA, Lisboa HR, Tres GS, Lavinsky J, Azevedo MJ (2006) Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes. Braz J Med Biol Res 39(8):1033–1039

    Article  CAS  Google Scholar 

  21. Doshi SM, Friedman AN (2017) Diagnosis and management of type 2 diabetic kidney disease. Clin J Am Soc Nephrol 12(8):1366–1373. https://doi.org/10.2215/CJN.11111016

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Liang S, Le W, Liang D, Chen H, Xu F, Chen H, Liu Z, Zeng C (2016) Clinico-pathological characteristics and outcomes of patients with biopsy-proven hypertensive nephrosclerosis: a retrospective cohort study. BMC Nephrol 17:42. https://doi.org/10.1186/s12882-016-0254-2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Tokuyama T, Ikeda T, Sato K (1998) Effect of plasma colloid osmotic pressure on intraocular pressure during haemodialysis. Br J Ophthalmol 82(7):751–753

    Article  CAS  Google Scholar 

  24. Sitprija V, Holmes JH, Ellis PP (1964) Changes in intraocular pressure during hemodialysis. Invest Ophthalmol 3:273–284

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

Esther Eshkol, MA, medical and scientific copyeditor, is thanked for editorial assistance

Funding

The authors received no financial support for the research, authorship, and/or publication of this article. Use of the Orion® software was provided free of charge by Voxeleron LLC.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Edith Wolfson Medical Center, 62 Halochamim St, Holon, Israel

    Idit Maharshak, Asaf Achiron, Oriel Spierer & Asaf Bar

  2. Department of Nephrology and Hypertension, Edith Wolfson Medical Center, Holon, Israel

    Aliza Grossbard, Anna Katkov, Relu Cernes & Leonid Feldman

  3. Department of Ophthalmology, Shamir Medical Center, Beer Yaakov, Israel

    Idan Hecht

  4. Department of Ophthalmology, Meir medical center, Kefar Sava, Israel

    Zvia Burgansky

  5. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Idit Maharshak, Idan Hecht, Asaf Achiron, Oriel Spierer, Zvia Burgansky, Asaf Bar, Aliza Grossbard, Anna Katkov, Relu Cernes & Leonid Feldman

  6. Department of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Lihi Mankuta

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  1. Idit Maharshak
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  2. Idan Hecht
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Contributions

IM and LF conceived and directed the project. AA, OS, ZB, AB, AG, AK, and RC recruited patients, analyzed data, and critically revised the manuscript. IH, IM, AA, and LM analyzed data and drafted the work. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Idit Maharshak.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures were in accordance with the Wolfson medical center research committee and in accordance with the 1964 Helsinki declaration and its later amendments.

Consent to publish

All participants agreed to the collection and anonymous publication of the data.

Informed consent to participate

Informed written consent was obtained from all participants prior to enrollment.

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Maharshak, I., Hecht, I., Mankuta, L. et al. The effect of hemodialysis on individual retinal layer thickness. Int Ophthalmol 41, 1233–1240 (2021). https://doi.org/10.1007/s10792-020-01677-x

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  • DOI: https://doi.org/10.1007/s10792-020-01677-x

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