title: Twenty-four-hour intraocular pressure monitoring in normotensive patients undergoing chronic hemodialysis.
abstract: OBJECTIVE
  To investigate 24-hour intraocular pressure (IOP) changes caused by hemodialysis (HD).
  
  
  METHODS
  A prospective, observational, comparative 24-hour trial was performed on consecutive subjects with normal IOP undergoing maintenance HD 3 days a week between 13:00 and 17:00 hours in an academic setting. Following a comprehensive ocular assessment, those with conditions that may influence IOP were excluded and one eye was randomly selected. Twenty-four-hour IOP monitoring was performed on HD day 1 and then on a day without HD. The IOP was measured at 10:00, 13:00, 15:00, 17:00, 22:00, 02:00, and 06:00 employing Goldmann and Perkins tonometry on habitual position. During the course of 1 year, 18 patients completed the study.
  
  
  RESULTS
  Monitoring of IOP on HD day showed a significantly higher mean 24-hour IOP (15.4 ± 2.7 vs 14.1 ± 2.2 mm Hg; p = 0.025), higher mean peak 24-hour IOP (18.5 ± 3.5 vs 15.8 ± 2.5 mm Hg; p = 0.003), and wider 24-hour IOP fluctuation (6.2 ± 2.3 vs 4.0 ± 1.9 mm Hg; p = 0.001). When individual time points were compared, IOP was significantly higher at 17:00 on HD day, reflecting a gradual IOP elevation during HD (p = 0.021). Further, during the HD procedure (13:00-17:00), the mean IOP was significantly higher on a HD day (16.4 ± 3.0 vs 14.7 ± 2.4 mm Hg; p = 0.004).
  
  
  CONCLUSIONS
  This prospective, before/after trial suggests that HD significantly impacts 24-hour IOP characteristics in normotensive eyes. The long-term significance of these findings requires further elucidation in normotensive patients and, predominantly, in patients with glaucoma undergoing HD.
authors.affiliation: Glaucoma Unit, 1 University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki - Greece.
authors.forename: Evangelia S
authors.initials: ES
authors.lastname: Panagiotou
authors.affiliation: Renal Unit, 1 University Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki - Greece.
authors.forename: Vassilios
authors.initials: V
authors.lastname: Liakopoulos
authors.affiliation: Glaucoma Unit, 1 University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki - Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Giannopoulos
authors.affiliation: Glaucoma Unit, 1 University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki - Greece.
authors.forename: Irini C
authors.initials: IC
authors.lastname: Voudouragkaki
authors.affiliation: Renal Unit, 1 University Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki - Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Demirtzi
authors.affiliation: Glaucoma Unit, 1 University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki - Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Paschalinou
authors.affiliation: Renal Unit, 1 University Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki - Greece.
authors.forename: Olga
authors.initials: O
authors.lastname: Nikitidou
authors.affiliation: Glaucoma Unit, 1 University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki - Greece.
authors.forename: Paraskevas V
authors.initials: PV
authors.lastname: Kapis
authors.affiliation: Glaucoma Unit, 1 University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki - Greece.|3 University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki - Greece.
authors.forename: Anastasios G P
authors.initials: AG
authors.lastname: Konstas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D002940:Circadian Rhythm / Q000502:physiology*; D063171:Corneal Pachymetry; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis / Q000503:physiopathology*; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011446:Prospective Studies; D006435:Renal Dialysis; D014065:Tonometry, Ocular