Background: The relation between the kidney disease and the eye has always been a subject of interest, their anatomical, developmental and genetic similarity, suggests the link between the kidney and eye diseases, also they share the same predisposing factors like diabetes, hypertension, oxidative stress and smoking. Chronic kidney disease is one of the known causes of retinopathyPurpose: To evaluate the effect of duration of longterm hemodialysis in chronic kidney disease (CKD) patients on the macular and optic nerve vasculature using optical coherence tomography angiography (OCTA). Methods: This cross-sectional observational study included 36 eyes of 36 patients with CKD on longterm hemodialysis of different durations of onset. We correlated the vessel density in the macula in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) and optic nerve head in the radial peripapillary capillary plexus (RPC) using OCTA to the duration of onset of longterm hemodialysis in these patients and to their laboratory findings as urea reduction ratio, urea level, creatinine and blood pressure.Results: Mean duration of hemodialysis was 6.11± 2.93 years. A negative correlation between the duration of hemodialysis and vessel density of the macular SCP and DCP and optic nerve head RPC, with statistical significance in SCP in PeriFoveal section (p, 0.045), RPC Inside Disc (p, 0.022) and in the RPC average Peripapillary area (p, 0.049). The correlation between the vessel density and the URR was positive, and with statistical significance in the SCP in PeriFoveal section, RPC average Peripapillary and Inside disc vessel density but a negative correlation has been found between the URR and the DCP Parafoveal section with no statistical significance.Conclusion: The macular SCP and DCP vessel density and optic nerve head RPC vessel density decrease with increase in the duration of longterm hemodialysis in chronic kidney disease (CKD) patients.