Effect of Hemodialysis on Intraocular Pressure and Ocular Perfusion Pressure

Hu, Jennifer J.; Bui, Kelly M.; Patel, Kunal; Kim, Hajwa; Arruda, José A.L.; Vajaranant, Thasarat S.

doi:10.1001/jamaophthalmol.2013.5599

Cited by 50 publications

(43 citation statements)

References 44 publications

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“…IOP is especially important for treating glaucoma. Although intraocular hypertension is not a requirement, it is still a significant risk factor in the development of glaucoma treatment (7,8). Lowering the IOP level is also the only effective treatment means to control the development of glaucoma in clinical practices.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the iCare rebound tonometer and the Goldmann applanation tonometer

Gao

Liu

Zhao

et al. 2017

Experimental and Therapeutic Medicine

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Tonometry is a fundamental procedure in routine ophthalmologic examination. Although regarded as the reference standard, the Goldmann applanation tonometer (GAT) has its limitations. A new portable alternative to the GAT is the iCare rebound tonometer (RT). The aim of the present study was to compare the intraocular pressure (IOP) results obtained using the RT and GAT and then correlate the results with the central corneal thickness (CCT). Moreover, the tolerability and safety of the RT were evaluated. The IOP of 336 patients (672 eyes) was determined by the RT and GAT. The patients were divided into three groups (group A, 7–15 mmHg, n=74; group B, 16–22 mmHg, n=218; and group C, 23–50 mmHg, n=44), based on the GAT IOP readings. Pachymetry and slit lamp inspection were also performed. To establish an agreement between the devices, a Bland-Altman analysis and paired t-test were performed. The correlation between CCT and IOP readings obtained by the two devices were assessed using linear regression correlation analysis. The mean IOP values of the RT and the GAT were 18.30±5.10 and 18.52±4.46 mmHg, respectively. There were no significant differences between them (t=−1.31, P=0.19). The 95% confidence interval of the differences between the two devices was −5.80–6.24 mmHg. The RT readings are correlated well with those of GAT (r=0.806, P=0.001). However, the RT measurements were significantly (t=−2.84, P=0.007) lower (−1.66±3.87 mmHg) than those obtained with GAT when GAT ≥23 mmHg. Both the RT (r=0.390, P=0.001) and the GAT (r=0.191, P=0.001) showed positive correlations with CCT. The IOP measurement with RT was well tolerated. None of the corneal epithelial defects was detected and all subjects denied discomfort. The RT is well tolerated and safe, and can be considered a reliable alternative to GAT for patients in a low to moderate IOP range. However, in patients with high IOP values, the measurements obtained with RT did not correlate well with those obtained by GAT. The RT readings are influenced more by CCT compared to GAT.

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Section: Discussionmentioning

confidence: 99%

Comparison of the iCare rebound tonometer and the Goldmann applanation tonometer

Gao

Liu

Zhao

et al. 2017

Experimental and Therapeutic Medicine

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“…8 There was a significant decrease in plasma osmolality and a significant increase in colloidal osmotic pressure, but neither of these correlated with IOP changes, which in themselves were significant. 8 There was a significant decrease in plasma osmolality and a significant increase in colloidal osmotic pressure, but neither of these correlated with IOP changes, which in themselves were significant.…”

Section: Rise In Iop With Hdmentioning

confidence: 83%

“…A recent study conducted in 49 patients found a significant increase in IOP and a decrease in OPP with HD. 8 There was a significant decrease in plasma osmolality and a significant increase in colloidal osmotic pressure, but neither of these correlated with IOP changes, which in themselves were significant. Instead, the authors found a significant relationship between IOP and OPP.…”

Section: Rise In Iop With Hdmentioning

confidence: 83%

Eyeing the complications of hemodialysis in the eye

Jindal

Misra

2014

Hemodialysis International

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The effect of hemodialysis (HD) on intraocular pressure (IOP) is variable and the exact mechanisms are not clear. Increased, decreased, as well as unchanged IOP has been described during HD in various case reports and studies. Patients with certain types of glaucoma and aqueous outflow obstruction of any other cause might be more susceptible to increase in IOP. This can cause severe eye pain, blurry vision, and headaches, causing significant morbidity for such dialysis patients. Certain changes in dialysis prescription may help relieve the above symptoms. There is a lack of awareness among nephrologists about the effects of HD on IOP. This may be especially relevant in the African American patients who besides having a higher risk of developing end-stage renal disease also have a higher risk of developing glaucoma. Recognition as well as management of signs and symptoms of elevated IOP in the dialysis population is significant morbidity and unnecessary work-up.

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“…15 Hu et al did not show a correlation with an increase in colloid osmotic pressures and decreased IOP. 25 They were able to show a positive correlation between increased ultrafiltration and increased colloid osmotic pressure.…”

Section: Increasing Fluid Removalmentioning

confidence: 96%

Ocular dialysis disequilibrium—Management of intraocular pressure during hemodialysis of open angle glaucoma: A case report and review of the literature

Lippold

Kalarn

Swamy

et al. 2019

Hemodialysis International

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It has been shown that patients with end‐stage renal disease (ESRD) have an increased risk for changes in intraocular pressure during hemodialysis, or ocular dialysis disequilibrium which can cause pain or discomfort during treatment and lead to decreased vision over time. This is a case of an elderly male with ESRD who was having headaches, nausea, and eye pain during hemodialysis due to increased intraocular pressures. Using a higher sodium prescription resolved his symptoms and normalized his intraocular pressures. This case illustrates that modification in dialysate tonicity can decrease changes in intraocular pressures while patients are on hemodialysis, a vision saving consideration for patients.

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Effect of Hemodialysis on Intraocular Pressure and Ocular Perfusion Pressure

Cited by 50 publications

References 44 publications

Comparison of the iCare rebound tonometer and the Goldmann applanation tonometer

Comparison of the iCare rebound tonometer and the Goldmann applanation tonometer

Eyeing the complications of hemodialysis in the eye

Ocular dialysis disequilibrium—Management of intraocular pressure during hemodialysis of open angle glaucoma: A case report and review of the literature

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