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Optical coherence tomography angiography analysis of changes in the retina and the choroid after hemodialysis for end stage kidney disease

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Abstract

Purpose

To study effects of hemodialysis (HD) on retinal and choroidal vasculature in patients with end-stage kidney disease (ESKD) using optical coherence tomography angiography (OCTA).

Methods

In this prospective study, we investigated eyes of patients undergoing hemodialysis for ESKD from Mondor University Hospital. Only one eye/patient was considered. Subfoveal choroidal thickness (SCT) was measured on enhanced-depth imaging optical coherence tomography (EDI-OCT) before and after the hemodialysis session. OCTA was used to extract retinal vascular density (superficial and deep capillary plexus, SCP, DCP) and choriocapillaris non-perfusion. Clinical, demographic and biological parameters (Blood B-Nitric Peptid rate prior to HD session) were reviewed.

Results

Twenty patients (mean age 53.2 ± 13.6 years, 10 males and 10 females) were included in this prospective study. SCT significantly decreased after the HD session (234.3 ± 56.14 µm before HD to 211.9 ± 60.79 µm after hemodialysis (Wilcoxon signed-rank test, p = 0.003)). Non-perfusion in the choriocapillaris significantly increased after HD (41.65 ± 3.58 before HD, 42.95 ± 3.19 after HD, p = 0.036) while no significant modification of the vascular density was observed in the retinal vasculature (SCP, DCP) around the macular zone or the optic nerve. An increased plasma B-Nitric Peptide (BNP) level prior to the onset of the HD session was significantly correlated with the decrease of the SCT (r = 0.45, p = 0.043).

Conclusion

Hemodialysis in patients with ESKD is associated with a significant decrease in SCT and an increase in non-perfusion in the choriocapillaris on OCTA. A High BNP level prior to the onset of the hemodialysis appears to be correlated with the decrease in SCT.

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Ophthalmology, University Paris Est Créteil, Centre Hospitalier Intercommunal de Créteil, 40, Avenue de Verdun, 94010, Créteil, France

    Samira Zegrari, Alexandra Mouallem, Eric H. Souied & Alexandra Miere

  2. Department of Nephrology, Henri Mondor Hospital, Créteil, France

    Vincent Audard, Narindra Jouan & Philippe Grimbert

  3. Clinical Research Center, GRC Macula and Biological Ressources Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France

    Camille Jung

  4. Department of Cardiology, Marie-Lannelongue Hospital, Plessis-Robinson, France

    Hichem Sakhi

Authors
  1. Samira Zegrari
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  2. Alexandra Mouallem
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  3. Vincent Audard
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  4. Narindra Jouan
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  5. Philippe Grimbert
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  6. Camille Jung
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  7. Hichem Sakhi
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  8. Eric H. Souied
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  9. Alexandra Miere
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Contributions

Alexandra MIERE (9) and Alexandra MOUALLEM (2) designed the study and developed the protocol. Vincent AUDARD (3), Narindra JOUAN (4) and Philippe GRIMBERT (5) were in charge of the patients who underwent hemodialysis for end-stage kidney failure. Eric H. SOUIED (8) reviewed the manuscript. Samira ZEGRARI (9) collected the data and wrote the manuscript. Hichem SAKHI (7) and Camille JUNG (6) provided the statistical analysis.

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Correspondence to Alexandra Miere.

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Zegrari, S., Mouallem, A., Audard, V. et al. Optical coherence tomography angiography analysis of changes in the retina and the choroid after hemodialysis for end stage kidney disease. Int Ophthalmol 43, 4473–4479 (2023). https://doi.org/10.1007/s10792-023-02847-3

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  • DOI: https://doi.org/10.1007/s10792-023-02847-3

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