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使用光学相干断层扫描技术评估非糖尿病血液透析患者的脉络膜和视网膜厚度测量值

Evaluation of choroidal and retinal thickness measurements using optical coherence tomography in non-diabetic haemodialysis patients.

作者信息

Ulaş Fatih, Doğan Ümit, Keleş Asena, Ertilav Muhittin, Tekçe Hikmet, Celebi Serdal

机构信息

Department of Ophthalmology, Abant Izzet Baysal University of Medicine, Bolu, Turkey,

出版信息

Int Ophthalmol. 2013 Oct;33(5):533-9. doi: 10.1007/s10792-013-9740-8. Epub 2013 Mar 1.

Abstract

The aim of this study is to evaluate the effects of haemodialysis with a high ultrafiltration rate on the choroidal and retinal thickness of non-diabetic end-stage chronic renal failure (CRF) patients using optical coherence tomography (OCT). Twenty-one eyes of 21 male CRF patients aged between 46 and 80 years were included in this prospective study. Retinal and choroidal thicknesses of the patients were measured using high-resolution OCT line scans with the activated enhanced depth imaging mode before and shortly after haemodialysis. Retinal and choroidal thickness measurements were taken at the fovea and at two points that were 1,500 μm nasal and temporal to the fovea. The relationships between the haemodynamic changes, intraocular pressure (IOP) and central corneal thickness (CCT) were also evaluated. The mean choroidal thicknesses before haemodialysis at the subfoveal, temporal and nasal locations were 232.81 ± 71.92, 212.43 ± 70.50 and 182.14 ± 68.88 μm, respectively. The mean choroidal thicknesses after haemodialysis at the subfoveal, temporal and nasal locations were 210.90 ± 65.53, 195.38 ± 66.48 and 165.19 ± 66.73 μm, respectively. There were significant differences between the choroidal thicknesses before and after haemodialysis (p < 0.001 for all). The mean retinal thicknesses before haemodialysis at the foveal, temporal and nasal locations were 215.86 ± 41.06, 308.86 ± 37.73 and 338.00 ± 33.32 μm, respectively. The mean retinal thicknesses after haemodialysis at the foveal, temporal and nasal locations were 216.90 ± 39.70, 313.86 ± 32.89 and 335.29 ± 36.85 μm, respectively. There was no significant difference between the retinal thicknesses before and after haemodialysis (p > 0.05 for all). The mean CCT decreased insignificantly from 550.48 ± 17.46 to 548.10 ± 21.12 μm (p = 0.411). The mean IOP decreased significantly from 14.09 ± 2.58 to 12.54 ± 2.23 mmHg (p = 0.003), which did not correlate with the CCT [r = (-)0.134, p = 0.562]. Haemodialysis with a high ultrafiltration volume did not alter the retinal thickness but caused a significant choroidal thinning and an IOP decrease in non-diabetic end-stage CRF patients.

摘要

本研究旨在利用光学相干断层扫描(OCT)评估高超滤率血液透析对非糖尿病终末期慢性肾衰竭(CRF)患者脉络膜和视网膜厚度的影响。本前瞻性研究纳入了21例年龄在46至80岁之间的男性CRF患者的21只眼睛。在血液透析前和透析后不久,使用激活的增强深度成像模式的高分辨率OCT线扫描测量患者的视网膜和脉络膜厚度。在黄斑中心凹以及黄斑中心凹鼻侧和颞侧1500μm处的两个点进行视网膜和脉络膜厚度测量。还评估了血流动力学变化、眼压(IOP)和中央角膜厚度(CCT)之间的关系。血液透析前,黄斑中心凹下、颞侧和鼻侧的平均脉络膜厚度分别为232.81±71.92、212.43±70.50和182.14±68.88μm。血液透析后,黄斑中心凹下、颞侧和鼻侧的平均脉络膜厚度分别为210.90±65.53、195.38±66.48和165.19±66.73μm。血液透析前后的脉络膜厚度存在显著差异(所有p<0.001)。血液透析前,黄斑中心凹、颞侧和鼻侧的平均视网膜厚度分别为215.86±41.06、308.86±37.73和338.00±33.32μm。血液透析后,黄斑中心凹、颞侧和鼻侧的平均视网膜厚度分别为216.90±39.70、313.86±32.89和335.29±36.85μm。血液透析前后的视网膜厚度无显著差异(所有p>0.05)。平均CCT从550.48±17.46μm无显著降低至548.10±21.12μm(p=0.411)。平均IOP从14.09±2.58mmHg显著降低至12.54±2.23mmHg(p=0.003),且与CCT不相关[r=(-)0.134,p=0.562]。高超滤量血液透析未改变非糖尿病终末期CRF患者的视网膜厚度,但导致脉络膜显著变薄和IOP降低。

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