Department of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany.
Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
Am J Kidney Dis. 2014 Mar;63(3):500-2. doi: 10.1053/j.ajkd.2013.08.034. Epub 2013 Nov 1.
A 64-year-old woman with end-stage renal disease and retinopathy secondary to type 2 diabetes mellitus presented with recurrent episodes of left ocular pain and acute loss of visual acuity during hemodialysis. During these episodes, markedly elevated intraocular pressures were measured. Several local and systemic antiglaucoma drugs were administered without improvement of intraocular pressure, resulting in the necessity of a glaucoma drainage device (Ahmed valve). Due to a local infection, it had to be removed, after which intraocular pressure elevations recurred during hemodialysis. Assuming that intraocular changes in osmolality during hemodialysis caused the intraocular pressure increases, intradialytic administration of a 20% glucose solution (100mL/h) was initiated. This completely abrogated the development of both intraocular pain and increases in intraocular pressure.
一位 64 岁的女性，患有终末期肾病和 2 型糖尿病性视网膜病变，在血液透析过程中出现反复左眼疼痛和急性视力丧失。在此期间，测量到显著升高的眼内压。尽管使用了多种局部和全身抗青光眼药物，但眼内压仍未改善，导致需要使用青光眼引流装置（ Ahmed 阀）。由于局部感染，不得不将其移除，此后在血液透析过程中眼内压再次升高。假设血液透析过程中眼内渗透压的变化导致眼内压升高，开始在血液透析期间给予 20%葡萄糖溶液（100mL/h）。这完全消除了眼内疼痛和眼内压升高的发展。
