MP638THE DURATION OF DIALYSIS AFFECTS CENTRAL CHOROIDAL THICKNESS IN DIALYSIS PATIENTS

Abstract

Introduction and Aims: Ocular problems are not uncommon among hemodialyzed patients. Uremic milieu, underlying disease and dialysis procedure might cause ocular problems such as diabetic retinopathy, glaucoma, corneal and conjunctival abnormalities (red eye), metastatic calcifications, cataracts and retinal diseases. Central choroidal thickness (CCT) changes before and after hemodialysis (HD) sessions have been investigated in a few studies. We evaluated choroidal thickness by enhanced depth imaging (EDI) mode of spectral domain optical coherence tomography (SD-OCT) in patients with end-stage renal disease (ESRD) undergoing HD. Methods: This study included right eyes of 14 ESRD patients undergoing HD and 15 controls. The patients with a best corrected visual acuity (BCVA) of 20/20 were included. Diabetics, patients with a history of anterior/posterior segment surgery, laser photocoagulation, intravitreal injection, ocular diseases such as glaucoma, uveitis, retinitis, age -related macular degeneration and optic neuropathy were excluded. All patients were examined at afternoon visits. The measurements were performed one day after dialysis session to avoid fluid fluctuations. Choroidal thickness (CT) is measured by using SD-OCT. Results: The dialysis duration of 14 (10 male, 4 female, 46.2±11.2 years) HD patients was 6.8±7.8 years. The mean intraocular pressure (IOP) was 12,7±1,63 mmHg, Spherical equivalent was 0.52±0.6 D, central CT was 369.42±89.61 μ in HD group. No significant difference was found in central CT between HD patients and control groups (369.42±89.61 μ vs 353.31±70.54 μ, respectively, p=0.375). Central CT was negatively correlated with duration of dialysis (r = - 0.827 p<0.001). Mean retinal nerve fiber layer thickness (RNFL) and mean central macular thickness (CMT) were found statistically significantly thicker than control patients (p=0.026 and p=0.006, respectively). Conclusions: HD patients have several extra-renal co-morbidities. Uremic milieu, dialysis modality, drugs and comorbidities contribute organ involvements in HD patients. Ocular problems are one of the extra renal involvements in HD patients. We conclude that duration of dialysis might be considered as an important predictor of ocular involvement in HD patients. (Figure presented).