Kianersi Farzan, Taheri Shahram, Fesharaki Shahin, Fesharaki Hamid, Mirmohammadkhani Majid, Pourazizi Mohsen, Ghalyani Maryam, Moghadam Ramin Shayan
Department of Ophthalmology, Isfahan Eye Research Center, Isfahan, Iran.
Department of Internal Medicine, Isfahan Kidney Diseases Research Center, Isfahan, Iran.
Int J Prev Med. 2019 Feb 12;10:20. doi: 10.4103/ijpvm.IJPVM_464_18. eCollection 2019.
Hemodialysis (HD)-associated ocular abnormalities are one of the causes of morbidity among people undergoing HD. This study evaluates the frequency of ocular abnormalities in end-stage renal disease (ESRD) patients undergoing HD and their potential link to HD and demographic parameters.
This cross-sectional study examined 242 eyes of 121 patients with ESRD undergoing regular HD after excluding the ineligible subjects. The study was designed in two parts. Medical histories of each patient including age, gender, family history, medication history, past medical history, and duration of HD collected using a structured check list. All patients underwent complete ophthalmologic examination for evaluation of the best corrected visual acuity (BCVA), intraocular pressure (IOP), and anterior and posterior segments.
In total, 121 patients, including 68 (56.2%) males and 53 (43.8%) females, were enrolled in the study. The mean ± SD age of the patients and their mean duration of dialysis were 51.59 ± 16.01 and 3.40 ± 2.75 years, respectively. The most prevalent etiology for HD was diabetes mellitus (39.67%), followed by hypertension (38.84%), and the most common ocular findings included cataract (142 eyes; 58.7%) and ectopic calcification of the conjunctiva and cornea (78 eyes; %32.2). There was at least one abnormal ocular finding in 89.3% of the cases. The BCVA was equal to or less than finger count in 70 eyes (28.92%). There was a significant relationship between conjunctival calcification and the duration of dialysis ( = 0.02). There was significant association between etiology of HD and conjunctival calcification (adjusted odds ratio, 2.44; 95% CI, 1.05-5.67; and value, 0.03). Such significant associations were present for corneal calcification ( = 0.009), cataract ( = 0.02), and optic atrophy ( = 0.01).
Regular ophthalmologic examinations are recommended due to the prevalence of clinical ocular abnormalities in HD patients.
血液透析（HD）相关的眼部异常是接受HD治疗的患者发病的原因之一。本研究评估了接受HD治疗的终末期肾病（ESRD）患者眼部异常的发生率及其与HD和人口统计学参数的潜在联系。
本横断面研究对121例接受定期HD治疗的ESRD患者的242只眼睛进行了检查，排除了不符合条件的受试者。该研究分为两个部分。使用结构化检查表收集每位患者的病史，包括年龄、性别、家族史、用药史、既往病史和HD治疗时间。所有患者均接受了全面的眼科检查，以评估最佳矫正视力（BCVA）、眼压（IOP）以及眼前段和眼后段。
总共121例患者纳入研究，其中男性68例（56.2%），女性53例（43.8%）。患者的平均年龄±标准差和平均透析时间分别为51.59±16.01岁和3.40±2.75年。HD最常见的病因是糖尿病（39.67%），其次是高血压（38.84%），最常见的眼部表现包括白内障（142只眼；58.7%）以及结膜和角膜异位钙化（78只眼；32.2%）。89.3%的病例至少有一项眼部异常发现。70只眼（28.92%）的BCVA等于或低于手动计数。结膜钙化与透析时间之间存在显著关系（P = 0.02）。HD病因与结膜钙化之间存在显著关联（调整后的优势比，2.44；95%可信区间，1.05 - 5.67；P值，0.03）。角膜钙化（P = 0.009）、白内障（P = 0.02）和视神经萎缩（P = 0.01）也存在此类显著关联。
由于HD患者临床眼部异常的普遍性，建议进行定期眼科检查。
