Evaluation of choroidal and retinal thickness measurements in adult hemodialysis patients using spectral-domain optical coherence tomography.
OBJECTIVE
To assess the effect of hemodialysis on retinal and choroidal thicknesses using spectral-domain optical coherence tomography (SD-OCT).


METHODS
In this prospective interventional study, 25 hemodialysis patients (17 male, 8 female) were enrolled. All participants underwent high-speed, high-resolution SD-OCT (λ=840 mm; 26.000 A-scans/s; 5 µm resolution) before and after hemodialysis. Choroidal thickness was measured perpendicularly from the outer edge of the retinal pigment epithelium to the choroid-sclera boundary at the fovea and at five additional points: 500 µm and 1000 µm nasal to the fovea and 500 µm, 1000 µm, and 1500 µm temporal to the fovea. Two masked physicians performed the measurements. Choroidal and retinal thicknesses before and after hemodialysis were compared.


RESULTS
The median choroidal thicknesses before and after hemodialysis were 182 µm (range, 103-374 µm) and 161 µm (range, 90-353 µm), respectively (P<0.001). The median retinal thicknesses were 246 µm (range, 179-296 µm) before and 248 µm (range, 141-299 µm) after hemodialysis (P>0.05). Systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, heart rate, and ocular perfusion pressure significantly decreased after hemodialysis (P<0.001). Intraocular pressure did not vary significantly (P=0.540).


CONCLUSIONS
Hemodialysis seems to cause a significant decrease in choroidal thickness, whereas it has no effect on retinal thickness. This significant decrease in choroidal thickness might be due to the extensive fluid absorption in hemodialysis, which could result in decreased ocular blood flow.
Department of Ophthalmology, School of Medicine, Baskent University, Konya, Turkey.
Ali
A
Kal
Department of Nephrology, School of Medicine, Baskent University, Konya, Turkey.
Oznur
O
Kal
Department of Ophthalmology, School of Medicine, Baskent University, Konya, Turkey.
Fatma Corak
FC
Eroglu
Department of Ophthalmology, School of Medicine, Izmir University, Izmir, Turkey.
Ozlem
O
Öner
Department of Ophthalmology, School of Medicine, Izmir University, Izmir, Turkey.
Cem
C
Kucukerdonmez
Department of Ophthalmology, School of Medicine, Baskent University, Ankara, Turkey.
Gürsel
G
Yılmaz
D000328:Adult; D002829:Choroid / Q000033:anatomy & histology* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005123:Eye / Q000098:blood supply; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007429:Intraocular Pressure; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009929:Organ Size; D011446:Prospective Studies; D012016:Reference Values; D006435:Renal Dialysis / Q000009:adverse effects*; D012160:Retina / Q000033:anatomy & histology* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018709:Statistics, Nonparametric; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods; D055815:Young Adult