Effect of Hemodialysis on Intraocular Pressure and Ocular Perfusion Pressure

医学 眼压 青光眼 眼科 血压 高眼压 内科学
作者
Jennifer J. Hu,Kelly M. Bui,Kunal Patel,Hajwa Kim,Jose A.L. Arruda,Jacob T. Wilensky,Thasarat S. Vajaranant
出处
期刊:JAMA Ophthalmology [American Medical Association]
卷期号:131 (12): 1525-1525 被引量:38
标识
DOI:10.1001/jamaophthalmol.2013.5599
摘要

Importance

Elevated intraocular pressure (IOP) and decreased ocular perfusion pressure (OPP) are risk factors for glaucoma development and progression. Unrecognized significant IOP elevation or OPP reduction during hemodialysis (HD) could lead to glaucomatous optic nerve damage and subsequent visual loss.

Objective

To evaluate changes in IOP and OPP during HD.

Design, Setting, and Participants

A cross-sectional observational study was conducted in patients undergoing HD at an ambulatory care clinic at the University of Illinois at Chicago.

Exposures

Forty-nine patients (97 eyes) undergoing HD were enrolled. Exclusion criteria included preexisting corneal abnormalities, history of corneal surgery, allergy to topical anesthetic agents, and current eye infection. Nine patients had previous diagnoses of open-angle glaucoma (OAG) or suspected glaucoma. At 3 time points, IOP was measured using a pneumatonometer and blood pressure was recorded. Measurements were made with the patient in a seated position approximately 15 minutes before starting HD (T1), approximately 2 hours after starting HD (T2), and approximately 15 minutes after ending HD (T3). Mean arterial pressure (MAP) and OPP (systolic, diastolic, and mean OPP) were calculated.

Main Outcomes and Measures

Intraocular pressure and OPP.

Results

From T1 to T3, IOP significantly increased by 3.1 mm Hg (both eyes,P < .001), MAP significantly decreased by 5.8 mm Hg (P = .05), and all OPP measures significantly decreased from baseline (allP ≤ .02). Using previously reported thresholds of increased glaucoma development and progression risk, 53% of the right eyes (26 of 49) and 46% of the left eyes (22 of 48) had a systolic OPP of 101 mm Hg or less, 71% of the right eyes (35 of 49) and 73% of the left eyes (35 of 48) had a diastolic OPP of 55 mm Hg or less, and 63% of the right eyes (31 of 49) and 65% of the left eyes (31 of 48) had a mean OPP of 42 mm Hg or less.

Conclusions and Relevance

Significantly increased IOP and decreased OPP occur during HD, bringing both to levels that increase the risk of glaucoma development and progression. Clinicians should consider HD history in patients who have glaucoma progression, even when IOP has been well controlled. Such patients may benefit from IOP and blood pressure monitoring during HD sessions to minimize OPP changes resulting from IOP spikes and/or suboptimal blood pressure.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
tough_cookie完成签到 ,获得积分10
刚刚
彩钢房完成签到,获得积分10
1秒前
MeSs完成签到 ,获得积分10
2秒前
toxikon完成签到,获得积分10
3秒前
一点通完成签到,获得积分10
3秒前
Lei完成签到,获得积分10
4秒前
4秒前
4秒前
常若冰完成签到,获得积分10
4秒前
纯真的元风完成签到,获得积分10
5秒前
哇哈哈哈完成签到,获得积分10
5秒前
清秋1001完成签到 ,获得积分10
6秒前
qq完成签到,获得积分10
7秒前
荒野风发布了新的文献求助10
8秒前
Zxx发布了新的文献求助10
9秒前
10秒前
10秒前
确幸完成签到 ,获得积分10
10秒前
苒苒完成签到,获得积分10
10秒前
11秒前
酷波er应助c123采纳,获得10
11秒前
TIAOTIAO完成签到,获得积分10
13秒前
未晚完成签到 ,获得积分10
13秒前
14秒前
14秒前
天天快乐应助qinglinglie采纳,获得10
14秒前
自由老头应助荒野风采纳,获得10
14秒前
本末倒纸发布了新的文献求助10
15秒前
15秒前
甜蜜老虎完成签到,获得积分10
15秒前
脑洞疼应助帅气的蚊子采纳,获得10
16秒前
你好完成签到 ,获得积分10
17秒前
18秒前
18秒前
XZZ完成签到 ,获得积分10
18秒前
19秒前
20秒前
小阿飞完成签到,获得积分10
21秒前
秀丽的初柔完成签到,获得积分10
21秒前
量子星尘发布了新的文献求助10
22秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
Research on Disturbance Rejection Control Algorithm for Aerial Operation Robots 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038619
求助须知:如何正确求助?哪些是违规求助? 3576294
关于积分的说明 11375058
捐赠科研通 3306084
什么是DOI,文献DOI怎么找? 1819374
邀请新用户注册赠送积分活动 892698
科研通“疑难数据库(出版商)”最低求助积分说明 815066