Background
Diabetes and hypertensive retinopathy are common preventable causes of blindness, and both are associated with risk of end-stage renal failure< /p>
The effect of hemodialysis on retinal morphology in patients with end-stage renal disease remains controversial: some studies have suggested that dialysis can improve macular edema in diabetic patients with chronic renal failure, while others have suggested that the retina after hemodialysis Thickness increases
Orion software can automatically generate detailed maps of individual retinal layer thicknesses from spectral domain optical coherence tomography images and provide a hitherto unobtainable quantitative view of different retinal layers
Overview
The purpose of this study was to use Orion software to assess the effect of hemodialysis on changes in retinal layer thickness for greater objectivity and greater sensitivity
This study is a non-randomized, prospective study
Subjects
Inclusion criteria:
End-stage renal disease patients over 18 years old
Dialysis using a high-throughput FX80/FX100 dialyzer in the dialysis room at Wolfson Medical Center between January 2018 and December 2018
Suffering from diabetes and/or hypertension
Normal retina on optical coherence tomography
Exclusion criteria:
Persistent episode of acute renal failure
Ocular disease (eg, mediators) opacity, cataracts)
and had undergone eye surgery, lasers, or injections within 3 months prior to enrollment
Interventions
Each subject was Non-invasive bilateral ocular examinations including spectral domain optical coherence tomography of the retinal nerve fiber layer and macula, intraocular pressure measurements, and central corneal thickness measurements were performed before and 60 minutes after dialysis
Outcome assessments
IOP and central corneal thickness were analyzed, and spectral domain optical coherence tomography results were automatically segmented using Orion software and compared.
Results
1
Baseline data
Of 31 patients who agreed to participate, 7 were unable to complete all assessments
Mean age was 66.67±14.3 years (range: 35-88), 62.5% were male
2
Endpoint events
Mean central corneal thickness did not change before and after hemodialysis (563.4±30.2 µm to 553.1±47.2 µm, p=.247), while mean IOP decreased (14.48 ±2.5 mmHg to 13.16±2.28 mmHg, p=.028) (bottom graph