Ocular effects of hemodialysis in non-diabetic chronic renal failure patients

Abstract

Objective: To evaluate effects of hemodialysis on best-corrected visual acuity (BCVA), spherical equivalent, central corneal thickness (CCT), intraocular pressure (IOP), macular volume, and retinal nerve fiber layer (RNFL) thickness in non-diabetic chronic renal failure (CRF) patients. Material and Methods: Twenty-four eyes of 20 male and 4 female CRF patients aged between 46-78 years (mean 61.13±10.31 years) were included in this cross-sectional study. BCVA, spherical equivalent, CCT, IOP, macular volume and RNFLthickness measurements of the patients were recorded before and after hemodialysis. Statistical analysis of the data was carried out using paired sample t-test, Wilcoxon signed rank test and Pearson correlation analysis. Results: Hemodialysis significantly decreased plasma osmolality (p<0.001), increased plasma colloid oncotic pressure (p<0.001) and did not alter mean arterial pressure (p=0.139). There was no statistically significant difference in BCVA, spherical equivalent, CCT and all evaluated macular segment volumes (p values were >0.05). IOP decreased significantly after hemodialysis (p=0.007). There was statistically significant increase in all RNFLsegments (p values for global, superotemporal, superonasal, inferotemporal and inferonasal segments were 0.005, 0.002, 0.021, 0.041 and 0.024, respectively) except in nasal and temporal RNFLsegments. There was no significant correlation between all measured parameters (p values were >0.05) except for moderate significant correlation between plasma colloid osmotic pressure difference and CCT difference (r=-0.451, p=0.027), and plasma colloid osmotic pressure difference and IOP difference (r=-0.415, p=0.044). Conclusion: Hemodialysis did not alter BCVA, spheric equivalent, CCT and macular volume, but altered IOP and RNFLthickness significantly in nondiabetic CRF patients. Ophthalmologic examination of CRF patients treated with hemodialysis must be performed at the same time point based on the time of the hemodialysis sessions. © 2014 by Türkiye Klinikleri.