Acquired night blindness due to rod dysfunction after long‐term haemodialysis

Abstract

AbstractPurpose: To report the clinical findings in 10 patients who developed night blindness after long‐term haemodialysis.Methods: The medical charts of the 10 patients were examined. The fundus photographs, spectral‐domain optical coherence tomographic (SD‐OCT) images, full‐field ERGs, and blood chemistry panels were analysed.Results: The mean age of the 10 patients (4 men) at the time of diagnosis was 70 years. The mean duration of the haemodialysis was 23 years. The visual acuity of the patients was preserved at 20/30 or better except in 1 eye. Ophthalmoscopy showed white flecks that were scattered over the midperipheral retina in all the eyes. SD‐OCT showed mild macular degeneration in 5 eyes. The scotopic ERGs elicited by dim flashes were absent, and those elicited by bright flashes had negative waveforms. The photopic ERGs were relatively well preserved. These data indicated a rod‐specific dysfunction that may account for the night blindness. The plasma concentration of vitamin A was within the normal range in 4 of the patients and slightly lower than the normal limit in 1 of the patients. Administration of vitamin A was performed for 1 patient, and the symptom of night blindness and scotopic ERGs were improved 3 months later.Conclusions: Long‐term haemodialysis can be associated with the night blindness that may be caused by vitamin A deficiency, even though the plasma concentration of vitamin A in these patients was within the normal range.