Alterations in ocular surface and corneal thickness in relation to metabolic control in patients with chronic renal failure
Alterations in ocular surface and corneal thickness in relation to metabolic control in patients with chronic renal failure
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DOI：
10.1111/j.1440-1797.2007.00805.x
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发表时间：
2007-08-01
期刊：
影响因子：
2.5
通讯作者：
Hasanreisoglu, Berati
中科院分区：
文献类型：
--
作者：
Aktas, Zeynep;Oezdek, Senguel;Hasanreisoglu, Berati
目的：慢性肾功能衰竭(CRF)血液透析患者可能会出现眼表改变和眼部症状。本研究旨在探讨慢性肾功能衰竭患者眼表改变及其与代谢控制的关系。方法：选择38例(75只眼)慢性肾功能衰竭血液透析患者。患者接受了全面的眼科检查、泪液破裂时间测试、角膜厚度测量和结膜印迹细胞学检查。结果：38例(75眼)患者最常见的表现为结膜钙化并伴有红眼(81.3%)和干眼(62.7%)。印迹细胞学分级为0级者占57.3%，2~3级者占40%，与结膜钙化程度呈正相关(R=0.486，P=0.0001)。血清钙、磷水平与结膜钙化程度呈正相关(分别为R=0.684，P=0.0001和R=0.428，P=0.0001)，与结膜印迹细胞学分级呈正相关(分别为R=0.587，P=0.0001和R=0.385，P=0.0001)。经配对t检验，平均角膜厚度显著降低(9.31±26.9µm)。结论：干眼症和刺激性症状是慢性肾功能衰竭患者的主要眼部症状。血清钙和磷水平似乎对CRF患者的眼部表现和症状有重要的预后意义。
Aim: Ocular surface changes and ocular symptoms may be encountered in patients with chronic renal failure (CRF) undergoing haemodialysis. The ocular surface changes and its relationship with metabolic control in CRF patients were aimed to be emphasized in this study.Methods: Thirty-eight CRF patients (75 eyes) undergoing haemodialysis were enrolled. Patients underwent a complete ocular examination together with Schirmer, tear break-up time tests, pachymetric measurements and conjunctival impression cytologies. Blood calcium, phosphate levels and total body volume changes after haemodialysis were recorded.Results: The most common findings were conjunctival calcification with red eye (81.3%) and dry eye (62.7%, according to tear break-up time test) in 75 eyes of 38 patients. Impression cytologies were graded as 0 in 57.3% of eyes and 2-3 in 40% of eyes showing positive correlation with the extent of conjunctival calcification (R= 0.486, P = 0.0001). Serum calcium and phosphate levels were also positively correlated with the degree of conjunctival calcification (R= 0.684, P = 0.0001 and R = 0.428, P = 0.0001, respectively) as well as with the grades of impression cytology (R = 0.587, P = 0.0001 and R = 0.385, P = 0.0001, respectively). Furthermore, the mean corneal thickness decreased significantly (9.31 +/- 26.9 mu m) following haemodialysis (Paired t-test, P = 0.002).Conclusion: Dry eye and irritational symptoms are major ocular symptoms in CRF patients. Serum calcium and phosphate levels seem to have a prognostic importance for the ocular findings and symptoms in patients with CRF.