title: Management of intraocular pressure elevation during hemodialysis of neovascular glaucoma: a case report.
abstract: BACKGROUND
  It is generally accepted that dialysis may lower plasma osmolality at a faster rate than changes in ocular osmolality. This osmotic difference causes water to migrate from the plasma into the aqueous humor, increasing intraocular pressure. Certain authors have described IOP increase in patients with narrow angles.
  
  
  METHODS
  Here we report a neovascular glaucoma patient who experienced a substantial increase in IOP associated with severe eye pain and blurred vision during sessions of dialysis. The patient had been refractory to several antiglaucoma drugs and improved after intravenous administration of 20% hyperosmotic glucose solution with dialysis and pan-retinal photocoagulation.
  
  
  CONCLUSIONS
  It is the first report in which intravenous glucose administration and reduction of neovascularization by argon laser pan-retinal photocoagulation successfully managed IOP increase during dialysis in neovascular glaucoma. Further clinical studies are required to confirm our results.
authors.affiliation: Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci s.n.c., 53100, Siena, Italy. paolofrezzotti@paolofrezzotti.it.
authors.forename: P
authors.initials: P
authors.lastname: Frezzotti
authors.affiliation: Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci s.n.c., 53100, Siena, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Menicacci
authors.affiliation: Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci s.n.c., 53100, Siena, Italy.
authors.forename: S A
authors.initials: SA
authors.lastname: Bagaglia
authors.affiliation: Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci s.n.c., 53100, Siena, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Mittica
authors.affiliation: Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci s.n.c., 53100, Siena, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Toto
authors.affiliation: Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci s.n.c., 53100, Siena, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Motolese
mesh_terms: D057908:Argon Plasma Coagulation; D015355:Glaucoma, Neovascular / Q000601:surgery*; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D007429:Intraocular Pressure / Q000187:drug effects* / Q000502:physiology; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D006435:Renal Dialysis / Q000009:adverse effects*; D013549:Sweetening Agents / Q000008:administration & dosage*
chemical_list: D013549:Sweetening Agents; D005947:Glucose