Retinal Light Sensitivity in Haemodialysis Patients: Single Center Experience

Walid H. Elrewihby

Abstract

The patients with end-stage renal disease (ESRD) treated with maintenance hem dialysis (HD) are at risk for development of eye disease. Deterioration of eyesight is due to worsening of hypertensive or diabetic retinopathy, ischemic optic neuropathy and central retinal vein occlusion. Retinal light sensitivity is an important measurable parameter of visual function. The aim of this study was to compare retinal light sensitivity between normal healthy subjects and HD, as well as to determine whether there is a correlation between visual field loss and the age of HD patients, duration of HD treatment and hypertensive retinopathy in HD patients. In 80 eyes of 40 HD patients (29 males and 11 females) aged 17-69 years (mean 42 years) on haemodialysis 13 to 96 months (mean 42 months) and 20 eyes of 10 controls, complete ocular examination were performed and visual field testing by the Easy field automated static perimetry utilizing static "white-on-white" stimulus presentations. Only 16 eyes 20% had obvious areas of reduced retinal light sensitivity on the greytone printout, with MD P values less than 5 %. In 17.5 % (14 eyes), PSD P values of less than 5 % were found. CPSD P values of less than 5 % were also observed in 17.5 % (14 eyes). We found 20 eyes (25%) with hypertensive retinopathies; 14 eyes (17.5%) with grade I hypertensive retinopathy and 6 eyes (7.5%) with grade II hypertensive retinopathy with no significant difference regarding the duration of hem dialysis (HD) and the degree of hypertensive retinopathy in funds examination or the reduction of retinal light sensitivity. Conclusion: 20 % significant reduction in retinal light sensitivity in the central visual field of our HD patients was observed without any effect regarding the duration of hem dialysis. Therefore ocular examination should be done more frequently in dialysis patients. Automated perimetry may act as an early detector of visual function loss before ischemic damage of macula.

 Keywords: Haemodialysis, Hypertension, Retinal light sensitivity, Neuropathy.

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