Ocular manifestations in patients with diabetes with end-stage renal disease

Abstract

PURPOSE: Diabetic nephropathy is the most common cause of kidney failure and end-stage kidney disease. The present study was undertaken to find ocular changes and complications associated with diabetic end-stage kidney disease. MATERIALS AND METHODS: A 1-year cross-sectional study was conducted in the department of ophthalmology at a tertiary care hospital in South India between January 2008 and December 2008 on 50 patients with diabetes mellitus undergoing renal hemodialysis. Patients were subjected to general physical examination, systemic examination, and ocular examination. Best-corrected visual acuity, intraocular pressure, and detailed examination of anterior and posterior segments were assessed. RESULTS: Male (74%) preponderance was observed, and 50% of the patients had age more than 60 years. Thirty-two (32%) of the patients had duration of renal dialysis <6 months. Twenty-six (26%) eyes had duration of vision loss within a year with duration of diabetes up to 4 years. Blurring of vision was the most important symptom noticed among the patients. Patients with decreased vision <6/24 were about 47%. Fifty-three percent of the patients had vision of 6/6–6/18. Eighty percent of the eyes had diabetic retinopathy in one or the other form. Overall ocular changes seen in patients were diabetic retinopathy (48%), hypertensive retinopathy (12%), and cataract (9%). Proliferative diabetic retinopathy was the most common (50%) cause of visual impairment. CONCLUSION: Patients with diabetic end-stage kidney diseases are at high risk of ocular morbidities. Timely screening and treatment may help to reduce the ocular morbidities in this group.

Keywords

• diabetes mellitus
• diabetic nephropathy
• diabetic retinopathy
• end-stage kidney disease