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Use of SD-OCT to quantitatively evaluate peripheral congestion in diastolic dysfunction with a role model in hemodialysis patients with end-stage renal disease.
, 2
Affiliations- Department of Ophthalmology, Dünyagöz Hospital, Sakarya, Türkiye
- Department of Cardiology, Kartal Research and Training Hospital, İstanbul, Turkey
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Abstract
Background: There is no practical quantitative tool to assess peripheral congestion in patients with congestive heart failure. In this study, we aimed to evaluate peripheral congestion by measuring the choroidal thickness with SD-OCT in patients with end-stage renal disease (ESRD). In addition, volume management by hemodialysis (HD) is often difficult in patients with ESRD. Volume overload or hypovolemia may increase morbidity and mortality in long-term HD patients. Therefore, it is important to determine the ideal ultrafiltration rate (UFR) for each patient. Also, we aimed to find data to help determine the ideal UFR.
Material and methods: Fifty HD patients with ESRD were divided into 3 groups according to diastolic functions. Patients with mild diastolic dysfunction were enrolled in Group1, those with moderate diastolic dysfunction were enrolled in Group 2, and those with severe diastolic dysfunction were enrolled in Group 3. The choroid was used to evaluate peripheral congestion, and choroidal thickness (CT) was measured by optical coherence tomography (OCT) before and after HD.
Results: The average CT before HD in Group 3 (259.3 ± 7.5 μm ) was significantly higher than in Group 1 (249.6 ± 9.4 μm) (p = 0.015). The average CT after HD in Group 3 (224.1 ± 5.2 μm ) was significantly higher than in Group 1 (232.4 ± 9.3 μm) (p = 0.033). The mean of DCT was significantly higher in Group 3 than in Group 1 (p < 0.001).
Conclusion: DCT was correlated with diastolic function in ESRD patients undergoing HD, and further evaluation of diastolic function before HD may play a role in finding the ideal UFR.
Abstract
Background: There is no practical quantitative tool to assess peripheral congestion in patients with congestive heart failure. In this study, we aimed to evaluate peripheral congestion by measuring the choroidal thickness with SD-OCT in patients with end-stage renal disease (ESRD). In addition, volume management by hemodialysis (HD) is often difficult in patients with ESRD. Volume overload or hypovolemia may increase morbidity and mortality in long-term HD patients. Therefore, it is important to determine the ideal ultrafiltration rate (UFR) for each patient. Also, we aimed to find data to help determine the ideal UFR.
Material and methods: Fifty HD patients with ESRD were divided into 3 groups according to diastolic functions. Patients with mild diastolic dysfunction were enrolled in Group1, those with moderate diastolic dysfunction were enrolled in Group 2, and those with severe diastolic dysfunction were enrolled in Group 3. The choroid was used to evaluate peripheral congestion, and choroidal thickness (CT) was measured by optical coherence tomography (OCT) before and after HD.
Results: The average CT before HD in Group 3 (259.3 ± 7.5 μm ) was significantly higher than in Group 1 (249.6 ± 9.4 μm) (p = 0.015). The average CT after HD in Group 3 (224.1 ± 5.2 μm ) was significantly higher than in Group 1 (232.4 ± 9.3 μm) (p = 0.033). The mean of DCT was significantly higher in Group 3 than in Group 1 (p < 0.001).
Conclusion: DCT was correlated with diastolic function in ESRD patients undergoing HD, and further evaluation of diastolic function before HD may play a role in finding the ideal UFR.
Keywords
end-stage renal disease; diastolic dysfunction; choroidal thickness; ultrafiltration rate
About this articleTitle
Use of SD-OCT to quantitatively evaluate peripheral congestion in diastolic dysfunction with a role model in hemodialysis patients with end-stage renal disease.
Journal
Issue
Vol 7 (2022): Continuous Publishing
Article type
Original paper
Pages
194-199
Published online
2022-11-16
Page views
3503
Article views/downloads
269
DOI
Bibliographic record
Ophthalmol J 2022;7:194-199.
Keywords
end-stage renal disease
diastolic dysfunction
choroidal thickness
ultrafiltration rate
Authors
Ibrahim Ozdemir
Süleyman Çağan Efe
References (18)- Leypoldt JK, Cheung AK, Delmez JA, et al. Relationship between volume status and blood pressure during chronic hemodialysis. Kidney Int. 2002; 61(1): 266–275.
- Chou JA, Kalantar-Zadeh K. Volume Balance and Intradialytic Ultrafiltration Rate in the Hemodialysis Patient. Curr Heart Fail Rep. 2017; 14(5): 421–427.
- Delaey C, Van De Voorde J. Regulatory mechanisms in the retinal and choroidal circulation. Ophthalmic Res. 2000; 32(6): 249–256.
- Shin YUn, Lee SE, Kang MHo, et al. Evaluation of changes in choroidal thickness and the choroidal vascularity index after hemodialysis in patients with end-stage renal disease by using swept-source optical coherence tomography. Medicine (Baltimore). 2019; 98(18): e15421.
- Gök M, Karabas VL, Emre E, et al. Evaluation of choroidal thickness via enhanced depth-imaging optical coherence tomography in patients with systemic hypertension. Indian J Ophthalmol. 2015; 63(3): 239–243.
- Altinkaynak H, Kara N, Sayın N, et al. Subfoveal choroidal thickness in patients with chronic heart failure analyzed by spectral-domain optical coherence tomography. Curr Eye Res. 2014; 39(11): 1123–1128.
- Smyth B, Chan C, Grieve S, et al. Predictors of Change in Left-Ventricular Structure and Function in a Trial of Extended Hours Hemodialysis. J Cardiac Fail. 2020; 26(6): 482–491.
- Jung JiW, Chin HS, Lee DH, et al. Changes in subfoveal choroidal thickness and choroidal extravascular density by spectral domain optical coherence tomography after haemodialysis: a pilot study. Br J Ophthalmol. 2014; 98(2): 207–212.
- Ishibazawa A, Nagaoka T, Minami Y, et al. Choroidal Thickness Evaluation Before and After Hemodialysis in Patients With and Without Diabetes. Invest Ophthalmol Vis Sci. 2015; 56(11): 6534–6541.
- Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016; 29(4): 277–314.
- Alm A, Bill A. Ocular Circulation. 9th ed. Mosby, St Louis 1992.
- Schuster AK, Leuschner A, Feretos C, et al. Choroidal thickness is associated with cardiovascular risk factors and cardiac health: the Gutenberg Health Study. Clin Res Cardiol. 2020; 109(2): 172–182.
- Mansouri K, Medeiros FA, Marchase N, et al. Assessment of choroidal thickness and volume during the water drinking test by swept-source optical coherence tomography. Ophthalmology. 2013; 120(12): 2508–2516.
- Ikuno Y, Maruko I, Yasuno Y, et al. Reproducibility of retinal and choroidal thickness measurements in enhanced depth imaging and high-penetration optical coherence tomography. Invest Ophthalmol Vis Sci. 2011; 52(8): 5536–5540.
- Malik J, Kudlicka J, Valerianova A, et al. Diastolic dysfunction in asymptomatic hemodialysis patients in the light of the current echocardiographic guidelines. Int J Cardiovasc Imaging. 2019; 35(2): 313–317.
- Antlanger M, Aschauer S, Kopecky C, et al. Heart failure with preserved and reduced ejection fraction in hemodialysis patients: prevalence, disease pre- diction and prognosis. Kidney Blood Press Res. 2017; 42(1): 165–176.
- Cause of hypoxemia during hemodialysis. N Engl J Med. 1981; 305(22): 1351–1352.
- Park J, Rhee CM, Sim JJ, et al. A comparative effectiveness research study of the change in blood pressure during hemodialysis treatment and survival. Kidney Int. 2013; 84(4): 795–802.