SHORT TERM EFFECT OF HEMODIALYSIS ON PERIPAPILLARY RETINAL NERVE FIBER LAYER AND MACULAR THICKNESS

Abstract

Objective: To determine the thicknesses of retinal nerve fiber layer (RNFL) and macula by fourier-domain (FD) optical coherence tomography (OCT) in diabetic patients with end-stage renal failure (ESRF) undergoing hemodialysis. Study Design: Cross-sectional study. Place and Duration of Study: Pakistan Naval Ship, Shifa Karachi, from Jan 2019 to Jul 2019 Methodology: Fifty four patients presenting to nephrology department who met the inclusion criteria were included in the study. Macular and retinal nerve fibre layer thicknesses were compared pre and post 30 minutes of hemodialysis and their correlation (r=-0.89) with age, duration of hemodialysis and gender was examined. Pre hemodialysis temporal, inferior, average retinal nerve fibre layer thicknesses were observed thinner than Post hemodialysis. Results: Pre-hemodialysis macular thicknesses were thinner than post hemodialysis. Thinning of Macular and RNFL showed a negative relationship with age and duration of hemodialysis (r=-0.89 &-0.76). Temporal, superior quadrants and average retinal nerve fiber layer thickness values were found statistically different in pre and post 30 minutes hemodialysis examination (p-value = 0.002, 0.001 & 0.0021) while, nasal and inferior quadrants were found statistically insignificant. Whereas in macula, temporal and superior quadrants were found statistically significant (p-value=0.005 & 0.002) and nasal, Inferior and average thickness were found statistically insignificant (p-value = 0.0641, 0.0594 & 0.083). Conclusion: Macular and retinal nerve fiber layer thicknesses of patients receiving hemodialysis were less than the normal population. Age has no effect on these thinning. The duration of hemodialysis effects more than gender. Hemodialysis session causes a consistent increase in superior quadrant retinal nerve fiber layer. Retinal nerve fiber layer and macula showed a negative relationship with age and duration of hemodialysis.