Multimodal ocular evaluation in hemodialysis patients

Area of Science:

• Ophthalmology
• Nephrology
• Cardiovascular Physiology

Background:

• End-stage renal disease (ESRD) requiring hemodialysis impacts systemic fluid and electrolyte balance.
• Ocular structures may be affected by fluid shifts and hemodynamic changes during hemodialysis.
• Understanding these ocular changes is crucial for managing the overall health of ESRD patients.

Purpose of the Study:

• To investigate the immediate effects of hemodialysis on ocular parameters.
• Specifically evaluating choroidal thickness, intraocular pressure (IOP), axial length, central corneal thickness (CCT), lens thickness, anterior chamber depth, and ocular pulse amplitude (OPA).

Main Methods:

• A cohort of end-stage renal disease patients undergoing hemodialysis was recruited.
• Ocular measurements including choroidal thickness (SD-OCT), IOP and OPA (dynamic contour tonometry), and anterior segment parameters (optical biometry) were taken before and after hemodialysis.
• Statistical analysis was performed on data from the right eyes.

Main Results:

• A significant decrease in subfoveal and peripheral choroidal thickness was observed post-hemodialysis (p < 0.001).
• Ocular pulse amplitude (OPA) also significantly decreased after hemodialysis (p < 0.001), with a strong correlation to choroidal thickness (R = 0.923).
• Intraocular pressure (IOP) showed a non-significant trend towards increase (p = 0.05), while axial length, CCT, lens thickness, and anterior chamber depth remained unchanged.

Conclusions:

• Hemodialysis leads to a significant reduction in choroidal thickness and OPA.
• These changes suggest a potential impact of fluid shifts on choroidal vascular volume and ocular hemodynamics.
• Avascular ocular structures and IOP appear to be less affected by acute hemodialysis sessions.