OBJECTIVE:
To assess correlation of IOP and OPP changes during Hemodialysis.
METHODS:
CKD patients-receiving hemodialysis for ≥ 1month were included. At 3 time points, IOP and BP measurement were done.15 minutes before initiation of HD (T1), 2 hours after initiation of HD (T2), and 15 minutes after ending HD (T3). Mean arterial pressure (MAP) and OPP (systolic, diastolic, and mean OPP) were calculated. Patients with MOPP, DOPP, SOPP below baseline and variation in IOP were reviewed every 3 months.
RESULTS:
From T1 to T3, IOP significantly increased by 2.7 mm Hg (both eyes, P=0.000), MAP significantly decreased by 10.13 mm Hg (P = 0.000), and all OPP measures significantly decreased from baseline (all P < 0 .001). Using previously reported thresholds of increased glaucoma development and progression risk, in both eyes 58% of had a SOPP of ≤101 mm Hg, 58% had a DOPP of ≤55 mm Hg, and 48% had a MOPP of ≤42 mm Hg.
At the end of our study period, 6 of 58 patients(below baseline OPP) were found to develop early glaucomatous field defects and early optic nerve head changes in both eyes at follow-up visits.
CONCLUSIONS:
Significantly increased IOP and decreased OPP occur during HD, bringing both to levels that increase the risk of glaucoma development and progression. Hence our study reveals the importance of screening and monitoring of IOP and characteristic early optic nerve head changes and early visual field changes of glaucoma in end-stage renal disease patients who are on hemodialysis
