Akihiro Ishibazawa1, Taiji Nagaoka2, Yoshiro Minami3, Manabu Kitahara4, Takanori Yamashita4, Akitoshi Yoshida2. 1. Department of Ophthalmology Asahikawa Medical University, Asahikawa, Japan 2Department of Ophthalmology, Nayoro City General Hospital, Nayoro, Japan. 2. Department of Ophthalmology Asahikawa Medical University, Asahikawa, Japan. 3. Department of Ophthalmology, Nayoro City General Hospital, Nayoro, Japan. 4. Department of Urology, Nayoro City General Hospital, Nayoro, Japan.
Abstract
PURPOSE: We evaluated the effect of hemodialysis on the choroidal thickness in patients with and without diabetes who have end-stage kidney disease (ESKD). METHODS: Forty-one patients with ESKD were recruited and divided into two groups: those with ESKD due to diabetic nephropathy (DM group, 37 eyes of 20 patients) and those with nondiabetic ESKD (NDM group, 40 eyes of 21 patients). Using spectral-domain optical coherence tomography (SD-OCT), the subfoveal choroidal thickness (SCT) was measured before and after hemodialysis, and the change ratio (ΔSCT [%]) was calculated. RESULTS: The SCT decreased in all eyes after hemodialysis. The ΔSCT value in the DM group (-12.6 ± 2.7%) was significantly (P = 0.00027) larger than that in the NDM group (-6.9 ± 2.3%). Moreover, the ΔSCT per body fluid removal (BFR [L]) in the DM group was significantly (P = 0.013) greater than in the NDM group. In the DM group, the mean ΔSCT in the eyes treated with panretinal photocoagulation (PRP; n = 19) was significantly (P = 0.035) larger than that in eyes not treated with PRP (n = 18). The relationship between the ΔSCT and BFR was not significant (R² = 0.0038, P = 0.80) in the DM group but was significant (R² = 0.54, P = 0.00013) in the NDM group. CONCLUSIONS: The current results may reflect that systemic fluid accumulation has a greater effect on the diabetic choroid, probably due to damage to the choroidal vasculature, in patients with ESKD.
PURPOSE: We evaluated the effect of hemodialysis on the choroidal thickness in patients with and without diabetes who have end-stage kidney disease (ESKD). METHODS: Forty-one patients with ESKD were recruited and divided into two groups: those with ESKD due to diabetic nephropathy (DM group, 37 eyes of 20 patients) and those with nondiabetic ESKD (NDM group, 40 eyes of 21 patients). Using spectral-domain optical coherence tomography (SD-OCT), the subfoveal choroidal thickness (SCT) was measured before and after hemodialysis, and the change ratio (ΔSCT [%]) was calculated. RESULTS: The SCT decreased in all eyes after hemodialysis. The ΔSCT value in the DM group (-12.6 ± 2.7%) was significantly (P = 0.00027) larger than that in the NDM group (-6.9 ± 2.3%). Moreover, the ΔSCT per body fluid removal (BFR [L]) in the DM group was significantly (P = 0.013) greater than in the NDM group. In the DM group, the mean ΔSCT in the eyes treated with panretinal photocoagulation (PRP; n = 19) was significantly (P = 0.035) larger than that in eyes not treated with PRP (n = 18). The relationship between the ΔSCT and BFR was not significant (R² = 0.0038, P = 0.80) in the DM group but was significant (R² = 0.54, P = 0.00013) in the NDM group. CONCLUSIONS: The current results may reflect that systemic fluid accumulation has a greater effect on the diabetic choroid, probably due to damage to the choroidal vasculature, in patients with ESKD.
Authors: Yong Un Shin; Sang Eun Lee; Min Ho Kang; Sang-Woong Han; Joo-Hark Yi; Heeyoon Cho Journal: Medicine (Baltimore) Date: 2019-05 Impact factor: 1.817