The Influence of Hemodialysis on Ocular Pressure Dynamics: An Observational Study on IOP and OPP Changes

Hemodialysis (HD) is a life-saving therapy for patients with end-stage renal disease (ESRD), yet its impact on ocular hemodynamics remains insufficiently characterized. Intraocular pressure (IOP) and ocular perfusion pressure (OPP) are critical determinants of ocular health, and their fluctuation during HD may predispose patients to complications, particularly in glaucoma.

To assess the effect of HD on IOP and OPP in patients on maintenance dialysis.

This observational study included 50 ESRD patients undergoing regular HD. IOP was measured using a noncontact tonometer, and OPP was calculated before and after dialysis sessions. Demographic, clinical, and hemodynamic parameters were recorded. Pre- and postdialysis values were compared using paired statistical tests.

Hemodialysis significantly increased IOP [right eye (RE): 13.56 ± 2.75 to 16.06 ± 1.97 mm Hg, p < 0.001; left eye (LE): 13.68 ± 2.67 to 16.51 ± 1.53 mm Hg, p < 0.001] and reduced OPP (RE: 49.2 ± 6.5 to 42.7 ± 5.8 mm Hg; LE: 47.6 ± 6.1 to 41.5 ± 5.7 mm Hg; both p < 0.001), with a mean decline of 7.6 mm Hg.

Hemodialysis significantly alters ocular pressure dynamics, with increased IOP and reduced OPP suggesting compromised ocular perfusion. Hypertension (HTN) and diabetes mellitus (DM) may exacerbate these effects. Although no acute ocular complications were observed, reduced OPP may increase the risk in patients with glaucoma or vascular disease. Routine ophthalmic monitoring and structured follow-up should be integrated into dialysis care.

Donepudi VSS, Devasena M MA, Annamalai R, et al. The Influence of Hemodialysis on Ocular Pressure Dynamics: An Observational Study on IOP and OPP Changes. J Curr Glaucoma Pract 2025;19(4):182-185.