Retinal findings in chronic kidney disease patients on hemodialysis

Abstract

Background Chronic kidney disease (CKD) is an irreversible condition that leads to progression to end-stage renal disease that requires hemodialysis or kidney transplantation for patient survival and these patients are at risk of developing many complications. In the present study, the retinal findings in CKD patients on hemodialysis are evaluated. Patients and methods This is a cross-sectional noninterventional study that was carried out on CKD patients on hemodialysis for at least 3 months in the Nephrology Unit, Tanta University, Egypt; 160 eyes of 80 patients were included over 6 months. A complete ophthalmic evaluation was performed. Color fundus and spectral domain optical coherence tomography were performed at presentation. Results The visual acuity ranged from 6/6 to 6/18 in 80 eyes, which represents 50%, from 6/24 to 6/60 in 62 eyes, which represents 38.75%, and from less than 6/60 to perception of light in 18 eyes, which represents 11.25%. Fundus examination revealed that eight eyes were normal (5%). Hypertensive retinal changes occurred in 82 eyes with variable degrees of retinopathy. Diabetic retinopathy was found in 30 (18.75%) eyes and macular degeneration was detected in 20 (12.5%) eyes. Retinal vasculitis occurred in two (1.25%) eyes, branch retinal vein occlusion was detected in six (3.75%) eyes, glaucomatous optic neuropathy was found in eight (5%) eyes and central retinal artery occlusion occurred in four (2.5%) eyes. Conclusion The most common visual problems in hemodialysis patients that lead to visual loss are hypertensive and diabetic retinopathy. Hence, it is mandatory to screen fundus changes in CKD to prevent loss of vision.