Optical Coherence Tomography Measurements Alteration in Patients with End-Stage Renal Disease after Hemodialysis.

IF 1.9 4区医学 Q2 OPHTHALMOLOGY

Ophthalmic Research Pub Date : 2025-10-03 DOI:10.1159/000548710

Sepehr Fekrazad, Golnar Hassanzadeh, Asma Mousavi, Shayan Shojaei, Mohammad Amin Salehi, Kian Najimi, Jay Chhablani, J Fernando Arevalo

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引用次数: 0

Abstract

Objectives: This systematic review and meta-analysis aimed to evaluate the effects of hemodialysis (HD) on ocular parameters in patients with end-stage renal disease (ESRD) using optical coherence tomography (OCT).

Methods: Adhering to PRISMA guidelines, we conducted a comprehensive search of PubMed, Scopus, and Embase databases up to June 26, 2023. Eligible studies included original research investigating retinal and choroidal OCT measurements before and after HD in human subjects. Meta-analyses were conducted using Stata 16, calculating weighted mean differences (WMD) and standardized mean differences (SMD) with 95% confidence. Meta-regression and subgroup meta-analysis were carried out for suitable parameters.

Results: 26 studies on 1,430 participants were included. Meta-analysis revealed a significant reduction in subfoveal choroidal thickness post-HD in diabetic and mixed patient groups (SMD = -0.24, P < 0.0001) but not in non-diabetic patients. No significant changes were observed in average choroidal thickness, foveal retinal thickness, peripapillary retinal nerve fiber layer thickness, or macular volume across all groups. Subgroup analyses based on OCT models, eye selection etc. largely mirrored overall findings, with some variations. Sensitivity analyses were generally consistent, and quality assessment indicated satisfactory to excellent study quality.

Conclusion: Hemodialysis generally exerts minimal effects on various ocular parameters. However, a notable reduction in subfoveal choroidal thickness was observed in diabetic and mixed ESRD populations, suggesting increased vulnerability of choroidal tissues in these groups. These findings underscore the importance of regular ophthalmologic monitoring for ESRD patients undergoing HD, particularly those with diabetes. Future research should address existing heterogeneities and explore the long-term ocular implications of repeated HD sessions.

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血液透析后终末期肾病患者的光学相干断层扫描测量改变。

目的：本系统综述和荟萃分析旨在利用光学相干断层扫描（OCT）评估血液透析（HD）对终末期肾病（ESRD）患者眼部参数的影响。方法：根据PRISMA指南，我们对PubMed、Scopus和Embase数据库进行了全面检索，截止到2023年6月26日。符合条件的研究包括调查HD患者前后视网膜和脉络膜OCT测量的原始研究。采用Stata 16进行meta分析，计算加权平均差异（WMD）和标准化平均差异（SMD），置信度为95%。对适宜的参数进行meta回归和亚组meta分析。结果：纳入26项研究，1430名受试者。荟萃分析显示，糖尿病和混合患者组hd后中央凹下脉络膜厚度显著降低（SMD = -0.24, P < 0.0001），但非糖尿病患者无此现象。各组平均脉络膜厚度、视网膜中央凹厚度、乳头周围视网膜神经纤维层厚度或黄斑体积均无显著变化。基于OCT模型、眼睛选择等的亚组分析在很大程度上反映了总体结果，但存在一些差异。敏感性分析基本一致，质量评价表明研究质量满意至优秀。结论：血液透析对眼部各项参数的影响较小。然而，在糖尿病和混合ESRD人群中观察到中央凹下脉络膜厚度明显减少，表明这些人群中脉络膜组织的易损性增加。这些发现强调了对接受HD的ESRD患者，特别是糖尿病患者进行定期眼科监测的重要性。未来的研究应解决现有的异质性，并探讨反复HD会话对眼部的长期影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ophthalmic Research 医学-眼科学

CiteScore

3.80

自引率

4.80%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Ophthalmic Research'' features original papers and reviews reporting on translational and clinical studies. Authors from throughout the world cover research topics on every field in connection with physical, physiologic, pharmacological, biochemical and molecular biological aspects of ophthalmology. This journal also aims to provide a record of international clinical research for both researchers and clinicians in ophthalmology. Finally, the transfer of information from fundamental research to clinical research and clinical practice is particularly welcome.