Olawoye O O, Ogunleye T, Sarimiye T F, Bello T O
Department of Ophthalmology, College of Medicine, University of Ibadan, Department of Ophthalmology, University College Hospital, Ibadan, Nigeria.
Department of Medicine, University College Hospital, Ibadan, Nigeria.
Niger J Clin Pract. 2018 Jul;21(7):942-944. doi: 10.4103/njcp.njcp_358_17.
Studies have reported that intraocular pressure (IOP) might change markedly during hemodialysis. We report the case of a 34-year-old Nigerian female with a 3-year history of chronic kidney disease secondary to chronic glomerulonephritis who presented with acute symptomatic elevation of IOPs following hemodialysis. She had no ocular complaints immediately before undergoing hemodialysis. She presented with a history of pain, redness, and mild blurring of vision in the left eye about 15 min after hemodialysis. Examination revealed circumciliary injection, shallow anterior chambers, and closed angles on gonioscopy in both the eyes. She was treated with pilocarpine (4%) four times daily and dorzolamide/timolol (2%/0.5%) twice daily combination eye drops with subsequent relief of symptoms and IOP reduction from an initial 48 and 74 mmHg to 10 and 12 mmHg for the right and left eyes, respectively. This case highlights the need for sensitization and awareness among renal physicians and ophthalmologists of the possibility of extremely high IOP during or immediately following hemodialysis. It also emphasizes the importance of gonioscopy and treatment of at-risk patients with narrow angles before hemodialysis.
研究报告称，血液透析期间眼压（IOP）可能会发生显著变化。我们报告了一例34岁的尼日利亚女性病例，该患者因慢性肾小球肾炎继发慢性肾病，病史3年，在血液透析后出现急性症状性眼压升高。在进行血液透析前，她没有眼部不适。血液透析后约15分钟，她出现左眼疼痛、发红和轻度视力模糊的症状。检查发现双眼睫状充血、前房浅，房角镜检查显示房角关闭。她接受了每日4次毛果芸香碱（4%）和每日2次多佐胺/噻吗洛尔（2%/0.5%）联合滴眼液治疗，随后症状缓解，眼压从最初右眼48 mmHg和左眼74 mmHg分别降至10 mmHg和12 mmHg。该病例强调了肾内科医生和眼科医生需要提高对血液透析期间或之后眼压极高可能性的认识。它还强调了在血液透析前对房角狭窄的高危患者进行房角镜检查和治疗的重要性。
