Changes in Intraocular Pressure and Choroidal Thickness after Hemodialysis in Chronic Renal Failure Patients

Woo Chun Jun; Woo Lee Seung

doi:10.3341/jkos.2013.54.5.752

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Jun and Seung: Changes in Intraocular Pressure and Choroidal Thickness after Hemodialysis in Chronic Renal Failure Patients

Original Article

J Korean Ophthalmol Soc 2013;54(5):752-756.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.5.752

Changes in Intraocular Pressure and Choroidal Thickness after Hemodialysis in Chronic Renal Failure Patients

Woo Chun Jun, MD, Woo Lee Seung, MD

¹Department of Ophthalmology, Dongguk University College of Medicine, Gyeongju, Korea

Address reprint requests to Seung Woo Lee, MD Department of Ophthalmology, Dongguk Unversity Gyeongju Hospital #87 Dong-daero, Gyeongju 780-350, Korea Tel: 82-54-770-8256, Fax: 82-54-772-9618, E-mail: meinkamf@hanmir.com

Received 20 April 20127 October 2012 Accepted 12 February 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the change of choroidal thickness and intraocular pressure (IOP) as a result of hemodialysis with chronic renal failure patients. In addition, the correlation between the change of choroidal thickness and IOP were evaluated.

Methods

A total of 48 eyes of 48 chronic renal failure patients undergoing hemodialysis were included in the present study. IOP, blood pressure (systolic and diastolic), serum osmolality, central corneal thickness (CCT), and choroidal thick-ness were measured before and after hemodialysis. Choroidal thickness was measured using spectral domain ocular co-herence tomography (SD-OCT).

Results

After hemodialysis, IOP significantly decreased from 14.9 ± 2.3 mm Hg to 14.3 ± 2.1 mm Hg ( p ＜ 0.001) and cho-roidal thickness significantly decreased from 352.2 ± 31.6 μ m to 306.6 ± 29.0 μ m ( p ＜ 0.001). The other factors that sig-nificantly decreased after hemodialysis included serum osmolality ( p ＜ 0.001) and blood pressure ( p ＜ 0.001) except CCT ( p = 0.285). There was a positive correlation between changes in IOP and choroidal thickness after hemodialysis (r = 0.319, p = 0.027).

Conclusions

Decreased choroidal volume and thickness due to fluid loss may be involved in the mechanism of decreased IOP during hemodialysis.

Keywords: Choroidal thickness, Hemodialysis, Intraocular pressure, Spectral domain ocular coherence tomography

References

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Figure 1.

Representative image of right eye in 51 year old male patient with chronic renal failure. The choroid is seen in cross-sec-tion image acquired by spectral domain optical coherence tomography (SD-OCT, Spectralis) (double-headed arrow). The choroidal thickness was measured vertically from the basal aspect of the retinal pigment epithelium to the inner surface of the sclera. Choroidal thickness was 350 μ m before hemodialysis (A) and 310 μ m after hemodialysis (B).

Table 1.

Value of each factor in 48 patients before and after hemodialysis

	Before hemodialysis	After hemodialysis	Change in value after hemodialysis	p-value^*
Intraocular pressure (mm Hg)	14.9 ± 2.3	14.3 ± 2.1	-0.6 ± 0.6	＜0.001
Central corneal thickness (μ m)	539.3 ± 29.1	537.3 ± 24.4	-1.98 ± 12.7	0.285
Systolic blood pressure (mm Hg)	156.4 ±1 2.7	145.5 ± 9.7	-10.8 ± 7.2	＜0.001
Diastolic blood pressure (mm Hg)	94.0 ± 13.0	89.1 ± 9.8	-4.9 ± 4.3	＜0.001
Serum osmolality (mOsm)	303.4 ± 13.0	282.5 ± 8.9	-20.9 ± 14.1	＜0.001
Choroidal thickness (μ m)	352.2 ± 31.6	306.6 ± 29.0	-45.5 ± 13.2	＜0.001

^* Statistical significance was calculated by paired t-test.

Table 2.

Relationship between changes of intraocular pressure and factors may affect intraocular pressure

	Factor	Age	Axial length	Refractive error	CCT (μ m)
Intraocular pressure	Pearson correlation	-0.186	-0.015	0.034	0.226
	p-value^*	0.251	0.928	0.815	0.123
	Factor	SBP (mm Hg)	DBP (mm Hg)	SO (mOsm)	ChT (μ m)
	Pearson correlation	0.046	0.024	0.152	0.319
	p-value^*	0.757	0.871	0.3	0.027

CCT = central corneal thickness; SBP = systolic blood pressure; DBP = diastolic blood pressure; SO = serum osmolality; ChT = chorodial thickness.

^* Statistical significance was calculated by correlation analysis (Pearson’s correlation coefficient).

Table 3.

Multiple linear regression testing the association between changes of intraocular pressure (IOP) and factors may affect changes of IOP

Factors	p-value^*
Age	0.524
CCT change (Before hemodialysis - After hemodialysis)	0.295
SO change (Before hemodialysis - After hemodialysis)	0.321
ChT change (Before hemodialysis - After hemodialysis)	0.037

CCT = central corneal thickness; SO = serum osmolality; ChT = choroidal thickness.

^* Statistical significance was calculated by multiple linear regression.

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