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Changes in choroidal thickness and mean ocular perfusion pressure with hemodialysis
Author(s) -
Cordeiro Sousa D.,
Leal I.,
Couceiro R.,
Bigotte Vieira M.,
Lopez N.,
Resina C.,
Neves F.,
Gomes da Costa A.,
Pinto F.,
MarquesNeves C.,
Proença H.
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2016.0626
Subject(s) - medicine , hemodialysis , perfusion , ophthalmology , prospective cohort study , applanation tonometry , hemodynamics , blood pressure , cardiology , nuclear medicine , arterial stiffness
Purpose The goals of hemodialysis (HD) in end‐stage renal disease (ESRD) are to remove uremic substances and to control the composition and volume of body fluid. Several associated systemic and ocular hemodynamic changes occurring along with HD have already been described. Our goal was to evaluate the changes in subfoveal choroidal thickness (SFCT) and mean ocular pressure perfusion (MOPP) in HD. Methods Prospective cohort study including 16 eyes of 16 black patients (8 women) under chronic HD. Macular enhanced depth imaging spectral domain ocular coherence tomography (EDI‐OCT) cross scans were performed and IOP measurements obtained using Tonopen ® 1 h before and 1 h after HD. Hemodynamic data was also obtained at both time points. MOPP was calculated as MOPP = 2/3(mean arterial pressure) – IOP. The same experienced operator manually measured SFCT using the EDI‐OCT built‐in caliper. STATA v.13.0 was used as statistical package. Results Mean age of ESRD patients was 46.81 ± 7.72 [range 28–60] years. The mean time under HD was 17.38 ± 14.67 months. After HD, SFCT increased from 245.38 ± 73.86 μ m to 269.13 ± 69.74 μ m (p < 0.001). Adjusting for age, a linear regression model revealed a strong relationship between SFCT and MOPP with hemodialysis (p < 0.01). Conclusions In our study of ESRD patients, SFCT increased with HD. Shifting of molecules and fluid between the blood and choroidal interstitium during HD may be involved in SFCT changes, which are correlated with MOPP fluctuations.