Choroidal Thickness Evaluation Before and After Hemodialysis in Patients With and Without Diabetes

Ishibazawa, Akihiro; Nagaoka, Taiji; Minami, Yoshiro; Kitahara, Manabu; Yamashita, Takanori; Yoshida, Akitoshi

doi:10.1167/iovs.15-16719

Cited by 30 publications

(38 citation statements)

References 36 publications

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“…Other studies showed opposing results in patients with and without DM, showing decreased SFCT after HD [26][27][28][29]. In some studies, further subgroup analysis showed significantly larger SFCT changes in the patients with DM than in those without [28,29]. The results of current study are consistent with these studies and support the hypothesis that DM and its effect on choroidal vasculature can lead to significant changes in SFCT after HD.…”

Section: Discussionsupporting

confidence: 86%

“…One study suggested that body weight loss and changes in serum osmolarity and SBP were significantly correlated with SFCT changes after HD [28]. Another study suggested that amount of body fluid removal was significantly correlated with the SFCT in patients without DM, but no in those with DM [29]. The results of our study showed that DM was the only factor significantly correlated with SFCT changes after HD.…”

Section: Discussionsupporting

confidence: 51%

“…In patients with DM, underlying DM choroidopathy can affect the choroidal changes after HD. A previous study has suggested that systemic fluid accumulation has a greater effect on the diabetic choroid due to diabetic choroidopathy in such patients [29]. Diabetic choroidopathy and the possibility of impaired choroidal autoregulation can result in large SFCT changes after HD.…”

Section: Discussionmentioning

confidence: 93%

“…There have been several studies investigating the SFCT changes after HD, although the results were somewhat controversial [25][26][27][28][29]. One study showed an increasing tendency of SFCT after HD.…”

Section: Discussionmentioning

confidence: 99%

“…However, the researchers did not use EDI OCT, and subgroup analysis was not performed according to the presence of DM [25]. Other studies showed opposing results in patients with and without DM, showing decreased SFCT after HD [26][27][28][29]. In some studies, further subgroup analysis showed significantly larger SFCT changes in the patients with DM than in those without [28,29].…”

Section: Discussionmentioning

confidence: 99%

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Changes in Choroidal Thickness after Hemodialysis and the Influence of Diabetes

Kang

Choi²,

Kim

et al. 2017

J Retin

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Purpose:To evaluate the changes in subfoveal choroidal thickness (SFCT) after hemodialysis (HD) and to investigate the possible impact of diabetes mellitus (DM). Methods: This prospective, interventional case series included 18 patients undergoing HD due to chronic renal failure. Mean SFCT was measured before (pre-HD) and after HD (post-HD), and the differences (ΔSFCT) were calculated for each eye. In addition, the ratio of SFCT change (%SFCT; ΔSFCT/baseline SFCT × 100, percent, %) was calculated. Results: Ten patients (55.6%) had DM as the underlying etiology for HD. The mean SFCT was 311.8 ± 64.9 μm (177.5-468.0 μm) pre-HD and 311.2 ± 65.1 μm (191.5-454.5 μm) post-HD (p = 0.877). The mean ΔSFCT was -4.4 ± 20.0 μm (-64.0 to 29.0 μm), and the mean %SFCT was 4.3 ± 4.4% (0 to 19.5%). The mean ΔSFCT was significantly larger in patients with DM than those without DM (-14.1 ± 18.2 μm and 7.8 ± 15.6 μm; p = 0.006), but the mean %SFCT was not significantly different between the groups (4.4 ± 5.5% and 4.2 ± 2.6%; p = 0.315). Conclusions:The mean SFCT was not significantly changed after HD. The change in mean SFCT was significantly larger in patients with DM than in those without.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Changes in Choroidal Thickness after Hemodialysis and the Influence of Diabetes

Kang

Choi²,

Kim

et al. 2017

J Retin

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Optical coherence tomography angiography analysis of changes in the retina and the choroid after hemodialysis for end stage kidney disease

Zegrari,

Mouallem,

Audard

et al. 2023

Int Ophthalmol

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Impact of Hemodialysis on Subfoveal Choroidal Thickness Measured by Optical Coherence Tomography: A Systematic Review and a Pooled Analysis of Self-Controlled Case Series

Mao

Zheng

et al. 2023

Ophthalmol Ther

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Introduction Hemodialysis (HD) has various effects on the body, including optimizing body fluid composition and volume, which may have an impact on subfoveal choroidal thickness (SCT) in individuals with end-stage kidney disease (ESKD). However, previous studies have produced conflicting results regarding the effect of HD on SCT in patients with ESKD. Therefore, we conducted a meta-analysis to investigate the influence of HD on SCT. Methods A comprehensive search of relevant studies and bibliographies was conducted using Embase, PubMed, and Web of Science databases up to September 2022. Weighted mean difference (WMD) and 95% confidence interval (CI) were used to summarize the SCT change. Heterogeneity and publication bias were assessed, and a random-effects model was employed for the meta-analysis. Subgroup analyses were also performed to evaluate the influence of factors such as diabetes mellitus (DM), the severity of diabetic retinopathy (DR), diurnal variation adjustment, optical coherence tomography (OCT) types, and OCT scan modes. Results A total of 15 studies involving 1010 eyes were eligible for this meta-analysis, including 552 diabetic eyes, 230 non-diabetic eyes, and the remaining 228 eyes were uncategorized. The meta-analysis revealed a significant reduction in SCT after HD (WMD = −13.66 μm; 95% CI −24.29 to −3.03 μm; z = −5.115, P < 0.0001). Subgroup analysis indicated a significant difference between the DM and non-DM groups (WMD = −24.10 μm vs. −15.37 μm, 95% CI −27.39 to −20.80 μm vs. −19.07 to −11.66 μm; P = 0.001). Additionally, the group with proliferative diabetic retinopathy (PDR) exhibited a more pronounced reduction in SCT (WMD = −28.66 μm; 95% CI −37.10 to −20.23; z = −6.660, P < 0.0001). Adjusting for diurnal variation, different types or scan modes of OCT did not significantly affect the results. Conclusion HD leads to a significant decrease in SCT among patients with ESKD, especially in patients with DM with PDR. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-023-00761-6.

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Choroidal Thickness Evaluation Before and After Hemodialysis in Patients With and Without Diabetes

Abstract: The current results may reflect that systemic fluid accumulation has a greater effect on the diabetic choroid, probably due to damage to the choroidal vasculature, in patients with ESKD.

Cited by 30 publications

References 36 publications

Changes in Choroidal Thickness after Hemodialysis and the Influence of Diabetes

Changes in Choroidal Thickness after Hemodialysis and the Influence of Diabetes

Optical coherence tomography angiography analysis of changes in the retina and the choroid after hemodialysis for end stage kidney disease

Impact of Hemodialysis on Subfoveal Choroidal Thickness Measured by Optical Coherence Tomography: A Systematic Review and a Pooled Analysis of Self-Controlled Case Series

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