Changes in various ocular parameters of patients undergoing hemodialysis

Purpose To assess the alterations in various ocular parameters in patients undergoing hemodialysis. Design Prospective, observational study. Methods The study included 113 eyes from 113 patients who underwent hemodialysis due to chronic kidney disease and acute kidney injury between January 2021 and August 2022. All participants underwent complete ophthalmic exam which included best corrected visual acuity (BCVA), slit lamp examination, intraocular pressure (IOP) measurement and dilated examination using slit lamp biomicroscope and indirect ophthalmoscope. Optical coherence tomography (OCT) was done for all patients before they underwent hemodialysis and central subfield thickness (CST), retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness were assessed. The ophthalmic exam and OCT scan were repeated within 1–2 h of hemodialysis. Results The mean age (+/- SD) of the study population was 42.14 ± 13.25 years, with 65.5% males. Most participants were aged 41–60 years. BCVA and IOP did not change significantly after hemodialysis ( p = 0.74 and p = 0.37, respectively). Retinal parameters showed significant changes, with decreased CST ( p < 0.001) and GCC thickness ( p = 0.04). There was no significant change in RNFL thickness ( p = 0.44). CST positively correlated with dialysate flow rate and negatively with blood flow rate. A weak correlation was found between GCC thickness and ultrafiltration and dialysate flow rate. Conclusion Hemodialysis causes alterations in retinal parameters with a decrease in the CST and GCC thickness.