Abstract
Diabetic nephropathy and retinopathy (DR) including diabetic macular edema (DME) are representative microvascular complications of diabetes. We conducted a retrospective multicenter study analyzing records from patients with DR (132 eyes in 70 patients) and end-stage renal diseases (ESRD) who underwent hemodialysis for the first time. We demonstrated that the central retinal thickness (CRT) values were significantly decreased (p < 0.0001), and the best-corrected visual acuity (BCVA) values were improved (p < 0.05) at 1, 3, 6, 9, and 12 months after hemodialysis initiation, in spite of a lack of specific ocular treatments for DME in 93.2% of eyes. We found a significant positive correlation in the rates of CRT changes between right and left eyes. The CRT reductions were greater in eyes with DME type subretinal detachment than in those with spongelike swelling and cystoid macular edema. The visual outcome gain was associated with the CRT reduction at 12 months in the eyes with good initial BCVA (≧20/50). Hemodialysis induction contributed to functional and anatomical improvements after 1 year, independently of initial laboratory values before the hemodialysis.
Highlights
Diabetic nephropathy and retinopathy (DR) including diabetic macular edema (DME) are representative microvascular complications of diabetes
The data of this retrospective multicenter study showed that DME and best-corrected visual acuity (BCVA) improved significantly after the induction of hemodialysis in the eyes with DR of patients with end-stage renal diseases (ESRD)
We showed that the central retinal thickness (CRT) reduction effects were maintained at least for 1 year
Summary
Diabetic nephropathy and retinopathy (DR) including diabetic macular edema (DME) are representative microvascular complications of diabetes. A study found significant reductions in macular thickness by OCT immediately after dialysis, but another one found no changes 30 minutes after hemodialysis[12,13] In these studies, the enrolled patients were already on dialysis, and the effect of the hemodialysis initiation is unclear. To clarify this issue, Hwang et al showed that central retinal thickness (CRT) decreased significantly at 1 month after the first hemodialysis[14]. Hwang et al showed that central retinal thickness (CRT) decreased significantly at 1 month after the first hemodialysis[14] These studies were small scaled and had short observation terms, and no studies have assessed the DME effects of hemodialysis initiation for longer periods. We conducted a large-scale, retrospective, multicenter study and assessed the temporal profiles of CRT and best-corrected visual acuities (BCVAs) for 1 year in patients with DM and ESRD after hemodialysis initiation
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