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CHANGES IN OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN PATIENTS WITH CHRONIC RENAL FAILURE UNDERGOING DIALYSIS FOR THE FIRST TIME

Hwang, Hyeseong, MD*; Chae, Ju Byung, MD, PhD*; Kim, Jin Young, MD; Moon, Byung Gil, MD; Kim, Dong Yoon, MD, PhD*

doi: 10.1097/IAE.0000000000002312
Original Study: PDF Only

Purpose: To investigate the spectral domain optical coherence tomography findings before and after dialysis in patients with diabetic end-stage renal disease undergoing dialysis for the first time.

Methods: A retrospective medical review of patients with diabetic end-stage renal disease who recently started dialysis was conducted. Spectral domain optical coherence tomography findings before and after initiation of dialysis were analyzed. Systemic blood pressure, body weight, estimated glomerular filtration rate, and serum levels of blood urea nitrogen, creatinine (Cr), albumin, hemoglobin (Hb), and total CO2 were measured before and 1 month after starting dialysis. The correlations between the changes in these variables and the degree of decrease of the central subfield thickness after initiation of dialysis were analyzed.

Results: A total 26 eyes from 15 patients were included. Among them, 14 started hemodialysis, and 1 started peritoneal dialysis. After initiation of dialysis, the incidence of any macular edema significantly decreased from 69.2% (18/26) to 26.9% (7/26) (P = 0.001). The central subfield thickness (317.92 ± 91.41 vs. 287.77 ± 57.55 μm, P = 0.006) and subfoveal choroidal thickness (313.31 ± 85.89 vs. 288.81 ± 92.02; P = 0.024) also significantly decreased. Improvement in blood urea nitrogen, Cr, Hb, and total CO2 levels in serum and estimated glomerular filtration rate was observed. A significant positive correlation between the amount of central subfield thickness decrease and the decrease in serum blood urea nitrogen was found (Pearson correlation coefficient: 0.481, P = 0.013).

Conclusion: Macular edema and central subfield thickness significantly decreased after initiation of dialysis in patients with diabetic chronic renal failure without any ocular treatment. This may be related to the improvement in uremia and volume overload after the initiation of dialysis.

In patients with diabetic end-stage renal disease undergoing dialysis for the first time, incidence of macular edema and central subfield thickness decreased after first-time dialysis. Significant positive correlation between amount of central subfield thickness decrease and serum blood urea nitrogen decrease was found.

*Department of Ophthalmology, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, Korea;

Department of Ophthalmology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea; and

HanGil Eye Hospital, Incheon, Korea and Department of Ophthalmology, Catholic Kwandong University of College of Medicine, Incheon, Korea.

Reprint requests: Dong Yoon Kim, MD, PhD, Department of Ophthalmology, College of Medicine, Chungbuk National University, 776, Sunhwan-1-Ro, Seowon-Gu, Cheongju 28644, Korea; e-mail: umlover9@gmail.com

Paper presented at 2018 the annual meeting of 117th Korean ophthalmology society, Gwangju, Korea.

None of the authors has any financial/conflicting interests to disclose.

H. Hwang and J. B. Chae have equally contributed to this work.

The author contributions were as follows: design of the study (D.K.); collection and management of the data (D.K. and H.H.); analysis and interpretation of the data (H.H., J.K., B.M., J.C., and D.K.); preparation of the manuscript, and statistical analysis and interpretation (H.H., J.K., B.M., J.C., and D.K.); review and approval of the manuscript (H.H., J.K., B.M., J.C., and D.K.).

© 2018 by Ophthalmic Communications Society, Inc.