Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease

Ulas, Fatih; YİĞİT, İrem Pembegül; EVREN, Özge; Balbaba, Mehmet

Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease

Mehmet BALBABA, (Fırat Üniversitesi, Tıp Fakültesi, Göz Anabilim Dalı, Elazığ, Türkiye)

Fatih ULAŞ, (Abant İzzet Baysal Üniversitesi, Tıp Fakültesi, Göz Anabilim Dalı, Bolu, Türkiye)

Özge EVREN, (Malatya Eğitim ve Araştırma Hastanesi, Göz Kliniği, Malatya, Türkiye)

İrem Pembegül YİĞİT (, Malatya Eğitim ve Araştırma Hastanesi, Nefroloji Kliniği, Malatya, Türkiye)

Glokom Katarakt

2 0

Yıl: 2019 Cilt: 14 Sayı: 3 Sayfa Aralığı: 140 - 144 Metin Dili: İngilizce İndeks Tarihi: 30-10-2020

Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease

Öz:

Purpose: The aim of this study was to evaluate changes in corneal biomechanical properties following hemodialysis using an ocular responseanalyzer (ORA) in non-diabetic end stage renal diseaseMaterials and Methods: We included one eye of 50 non-diabetic chronic renal failure patients (25 females and 25 males) with a mean age of56.94 ± 9.95 years (range 36-80 years) in this cross-sectional study. Corneal compensated intraocular pressure (IOPcc), corneal hysteresis (CH)and the corneal resistance factor (CRF) were measured for included the eye of each participant using an ORA before and after hemodialysis.Central corneal thickness (CCT), blood pressure, plasma osmolality and plasma colloid osmotic pressure were also measured before and afterthe hemodialysis session. A paired samples t-test and Pearson’s correlation analysis were carried out for statistical analysis.Results: The mean CCT, IOPcc, CH and CRF of the patients before hemodialysis were 550.20±19.64 μm, 16.84±3.20 mmHg, 10.68±2.41mmHg and 11.36±2.50 mmHg, respectively. The mean CCT, IOPcc, CH and CRF of the patients after hemodialysis were 547.30±19.83 μm,15.61±2.77 mmHg, 11.38±2.91 mmHg and 11.37±2.96 mmHg, respectively. The mean plasma osmolality, plasma colloid oncotic pressure andmean arterial pressure (MAP) of the patients before hemodialysis were 309.12±9.10 mOsm/L, 23.86±1.49 mmHg and 99.74±12.84 mmHg,respectively. The mean plasma osmolality, plasma colloid oncotic pressure and mean arterial pressure (MAP) of the patients after hemodialysiswere 293.74±8.82 mOsm/L, 28.72±2.19 mmHg and 87.53±10.98 mmHg, respectively. Signifi cant changes occurred in IOPcc, CH, meanarterial pressure, serum osmolality and plasma colloid oncotic pressure (p values of 0.006, 0.036, <0.001, <0.001 and <0.001, respectively).There was no signifi cant difference in the CRF or CCT values before and after hemodialysis (p values of 0.980 and 0.084, respectively). Therewere signifi cant moderate correlations between differences in IOPcc and CH (r=-0.369, p=0.008) and MAP and CH (r=0.355, p=0.011).Conclusion: Hemodialysis did not alter CCT and CRF but caused a signifi cant IOP decrease and CH increase in non-diabetic chronic renalfailure patients that need be taken into account during the evaluation of IOP in hemodialysis patients.

Anahtar Kelime:

Diyabetik Olmayan Son Dönem Böbrek Hastalığında Hemodiyaliz Sonrası Kornea Biyomekanik Özelliklerinde Görülen Değişiklikler

Öz:

Amaç: Diyabetik olmayan son dönem böbrek yetmezliği olan hastalarda oküler cevap analizörü kullanarak (OCA) hemodiyalizi takiben korneanın biyomekanik özelliklerinde görülen değişimleri değerlendirmek Gereç ve Yöntem: Bu kesitsel çalışmaya ortalama yaşları 56.94 ± 9.95 yıl olan 50 diyabetik olmayan kronik böbrek yetmezliği olan hastanın (25 erkek ve 25 kadın) tek gözleri dahil edildi. Korneal kompanse göz içi basıncı (GİBkk), korneal histerezis (KH) ve korneal direnç faktör (KDF) hemodiyaliz öncesi ve sonrası OCA kullanılarak ölçüldü. Aynı zamanda santral korneal kalınlık (SKK), kan basıncı, plazma osmolalitesi ve plazma kolloid onkotik basınç hemodiyaliz öncesi ve sonrası ölçüldü. İstatiksel analiz için eşleştirilmiş örneklem t-testi ve Pearson korelasyon analizi kullanıldı. Bulgular: Hemodiyaliz öncesi hastaların ortalama SKK, GİBkk, KH ve KDF değerleri sırasıyla 550.20±19.64 μm, 16.84±3.20 mmHg, 10.68±2.41 mmHg ve 11.36±2.50 mmHg, hemodiyaliz sonrası hastaların ortalama SKK, GİBkk, KH ve KDF değerleri sırasıyla 547.30±19.83 μm, 15.61±2.77 mmHg, 11.38±2.91 mmHg ve 11.37±2.96 mmHg olarak ölçüldü. Hemodiyaliz öncesi hastaların ortalama plazma osmolalitesi, plazma kolloid onkotik basınç ve ortalama arteryel basınç (OAB) değerleri sırasıyla 309.12±9.10 mOsm/L, 23.86±1.49 mmHg ve 99.74±12.84 mmHg, hemodiyaliz sonrası hastaların ortalama plazma osmolalitesi, plazma kolloid onkotik basınç ve OAB değerleri sırasıyla 293.74±8.82 mOsm/L, 28.72±2.19 mmHg ve 87.53±10.98 mmHg olarak ölçüldü. GİBkk, KH, OAB, plazma osmolalitesi ve plazma kolloid onkotik basınçta önemli değişiklikler meydana geldi. (p değerleri sırasıyla, 0.006, 0.036, <0.001, <0.001 ve <0.001). Hemodiyaliz öncesi ve sonrası KDF ve SKK değerleri arasında önemli bir fark yoktu. (p değerleri sırasıyla, 0.980 ve 0.084). GİBkk ve KH (r=-0.369, p=0.008) ve OAB ve KH (r=0.355, p=0.011) arasında önemli orta derecede ilişki mevcuttu. Sonuç: Hemodiyaliz, GİB değerlendirilmesinde dikkate alınması gereken diyabetik olmayan son dönem kronik böbrek yetmezliği olan hemodiyaliz hastalarında SKK ve KDF’de değişikliğe neden olmamaktadır fakat önemli derecede GİBkk’da azalma, KH’de artışa sebep olmaktadır.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Bibliyografik

1. Tomazzoli L, De Natale R, Lupo A, et al. Visual acuity disturbances in chronic renal failure. Ophthalmologica 2000; 214:403-5.
2. Hu J, Bui KM, Patel KH, et al. Effect of hemodialysis on intraoculer pressure and ocular perfusion pressure. JAMA Ophthalmol. 2013;131:1525-31.
3. Elbay A, Altınışık M, Dinçyıldız A, Kutlutürk I, Canan J, Akkan U, et al. Are the effects of hemodialysis on ocular parameters similar during after a hemodialysis session. Arq Bras Opthalmol. 2017;80:290-5.
4. Chelala E, Dirani A, Fadlallah A, et al. Effect of hemodialysis on visual acuity, intraocular pressure and macular thickness in patients with chronic kidney disease. Clin Ophthalmol.2015;9:109-14.
5. Broekema N, Van Bijsterveld OP, De Bos Kuil RJ. Intraocular pressure during hemodialysis. Ophthalmologica 1988;197:60-4.
6. Dinç UA, Özdek Ş, Aktaş Z, et al. Changes in intraocular pressure and corneal and retinal nerve fi ber layer thickness during hemodialysis. Int Ophthalmol. 2010;30:337-40.
7. Jung JW, Yoon MH, Lee SW, et al. Effect of hemodialysis (HD) on intraocular pressure, ocular surface, and macular change in patients with chronic renal failure: Effect of hemodialysis on the ophthalmologic fi ndings. Graefe's Arch Clin Exp Ophthalmol. 2013;251:153-62.
8. Yaoeda K, Fukushima A, Shirakashi M, et al. Comparision of intraocular pressure adjusted by central corneal thickness or corneal biomechanical properties as measured in glaucomatous eyes using noncontact tonometers and the goldman applanation tonometer. Clin Ophthalmol.2016;11:829-34.
9. Kotecha A, Elsheikh A, Roberts CR, et al. Corneal thickness and age-related biomechanical properties of the cornea measured with the ocular response analyzer. Inv Ophthalmol Vis Sci. 2006;47:5337-47.
10. Luce DA. Determining in vivo biomechanical properties of the cornea with an ocular response analyzer. J Cataract Refract Surg. 2005;31:156-62.
11. Martinez-de-la-Casa JM, Garcia-Feijoo J, Fernandez-Vidal A, et al. Ocular response analyzer versus Goldmann applanation tonometry for intraocular pressure measurements. Inv Ophthalmol Vsi Sci. 2006;47:4410-4.
12. Oncel B, Dinç UA, Gorgun E, et al. Diurnal variation of corneal biomechanics and intraocular pressure in normal subjects. Eur J Ophthalmol. 2009;19:798-803.
13. Shen M, Wang J, Qu J, et al. Diurnal variation of ocular hysteresis, corneal thickness, intraoculer pressure. Optom Vis Sci. 2008;85:1185-92.
14. Medeiros FA, Weinreb RN. Evaluation of the infl uence of corneal biomechanical properties in intraocular pressure measurements using the ocular response analyzer. J Glaucoma 2006;15:364-70.
15. Yuksel N, Duru N, Uz E, et al. Evaluation of intraoculer pressure by Oculer Response Analyzer in patients undergoing hemodialysis. J Glaucoma 2016;25(4):355-8.
16. Congdon NG, Broman AT, Baanden-Roche K, et al. Central corneal thickness and corneal hysteresis associated with glaucoma damage. Am J Ophthalmol. 2006;141:868-75.
17. Park K, Shin J, Lee J. Relationship between corneal biomechanical properties and structural biomarkers in patients with normaltension glaucoma:a retrospective study. BMC Ophthalmol. 2018;18:7. doi: 10.1186/s12886-018-0673-x.
18. Brown L, Foulsham W, Pronin S, et al. The infl uence of corneal biomechanical properties on intraocular pressure measurements using a rebound self tonometer. J Glaucoma 2018;27:511-8.
19. Fontes BM, Ambrosio Jr R, Jardim D, et al. Corneal biomechanical metrics and anterior segment parameter in mild keratoconus. Ophthalmology 2010;117:673-9.
20. Goldich Y, Barkana Y, Gerber Y, et al. Effects of diabetes mellitus on biomechanical parameters of the cornea. J Cataract Refract Surg. 2009;35:715-9.
21. Hussnain SA, Alsberge JB, Ehrlich JR, et al. Change in corneal hysteresis over time in normal, glaucomatous and diabetic eyes. Acta ophthalmol. 2015;93:627-30.
22. Diaz-Couchoud P, Bordas FD, Garcia JR, et al. Corneal disease in patients with chronic renal insuffi ciency undergoing hemodialysis. Cornea 2001;20:695-702.
23. Costagliola C, Mastropasqua L. The infl uence of hemodialysis on intraocular pressure. III. Aqueous humor dynamics and tıssue hydration. Ann Ophthalmol. 1991;23:31-4.
24. Ulaş F, Balbaba M, Çelebi S. Effects of a water-loading test on intraocular pressure and corneal hysteresis in young healthy subjects. J Glaucoma 2014;23:101-4.

APA	Balbaba M, Ulas F, EVREN Ö, YİĞİT İ (2019). Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease. , 140 - 144.
Chicago	Balbaba Mehmet,Ulas Fatih,EVREN Özge,YİĞİT İrem Pembegül Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease. (2019): 140 - 144.
MLA	Balbaba Mehmet,Ulas Fatih,EVREN Özge,YİĞİT İrem Pembegül Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease. , 2019, ss.140 - 144.
AMA	Balbaba M,Ulas F,EVREN Ö,YİĞİT İ Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease. . 2019; 140 - 144.
Vancouver	Balbaba M,Ulas F,EVREN Ö,YİĞİT İ Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease. . 2019; 140 - 144.
IEEE	Balbaba M,Ulas F,EVREN Ö,YİĞİT İ "Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease." , ss.140 - 144, 2019.
ISNAD	Balbaba, Mehmet vd. "Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease". (2019), 140-144.

APA	Balbaba M, Ulas F, EVREN Ö, YİĞİT İ (2019). Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease. Glokom Katarakt, 14(3), 140 - 144.
Chicago	Balbaba Mehmet,Ulas Fatih,EVREN Özge,YİĞİT İrem Pembegül Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease. Glokom Katarakt 14, no.3 (2019): 140 - 144.
MLA	Balbaba Mehmet,Ulas Fatih,EVREN Özge,YİĞİT İrem Pembegül Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease. Glokom Katarakt, vol.14, no.3, 2019, ss.140 - 144.
AMA	Balbaba M,Ulas F,EVREN Ö,YİĞİT İ Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease. Glokom Katarakt. 2019; 14(3): 140 - 144.
Vancouver	Balbaba M,Ulas F,EVREN Ö,YİĞİT İ Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease. Glokom Katarakt. 2019; 14(3): 140 - 144.
IEEE	Balbaba M,Ulas F,EVREN Ö,YİĞİT İ "Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease." Glokom Katarakt, 14, ss.140 - 144, 2019.
ISNAD	Balbaba, Mehmet vd. "Changes in Corneal Biomechanical Properties Following Hemodialysis in Non-Diabetic End Stage Renal Disease". Glokom Katarakt 14/3 (2019), 140-144.