J Korean Ophthalmol Soc.  2009 Aug;50(8):1167-1173. 10.3341/jkos.2009.50.8.1167.

Tear Film and Ocular Surface Changes in Chronic Renal Failure Patients Undergoing Hemodialysis

• Lee SH
• Kim HR
• Yoon KC

• KMID: 2212529
• DOI: http://doi.org/10.3341/jkos.2009.50.8.1167

Abstract

PURPOSE
To evaluate the changes of tear film and ocular surface in patients with chronic renal failure (CRF) undergoing hemodialysis. METHODS: In 50 eyes of 25 CRF patients undergoing hemodialysis and 30 eyes of 15 control subjects, tear break-up time (BUT), basal tear secretion (BST), corneal sensation, tear clearance rate (TCR), keratoepitheliopathy and impression cytology findings were compared. Correlation between the above parameters and local or systemic factors was analyzed. RESULTS: Tear BUT, BST, TCR, conjunctival squamous metaplasia and conjunctival goblet cell density in the patient and control groups were 7.7+/-3.8 and 11.1+/-2.9 sec, 7.0+/-3.1 and 14.0+/-6.2 mm, 3.5+/-1.2 and 4.5+/-0.7, 1.5+/-0.6 and 0.3+/-0.5, 6.5+/-1.7 and 24.3+/-21.4 cells/mm2. Osmolarity in serum and tears of the patient group was higher than that of the control group. Serum and tear osmolarity correlated with BST, corneal sensation and conjunctival goblet cell density, and serum creatine level correlated with conjunctival goblet cell density (p<0.05). CONCLUSIONS: Patients with CRF undergoing hemodialysis have an increased risk of dry eye and thus, serum and tear osmolarity in dry eye patients should be closely monitored.

Keyword

Chronic renal failure; Dry eye syndrome

MeSH Terms

Creatine
Dry Eye Syndromes
Eye
Goblet Cells
Humans
Kidney Failure, Chronic
Metaplasia
Osmolar Concentration
Renal Dialysis
Sensation
Tears
Creatine

Figure

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  Figure 1. Impression cytologic findings. (A) Specimen from a patient with chronic renal failure undergoing hemodialysis shows a loss of goblet cells and large, polygonal epithelial cells. (B) Specimen from a normal subject shows many periodic acid-Schiff positive goblet cells and small, round epithelial cells.

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  Figure 2. Correlation between corneoconjunctival calcification (grade) and serum calcium (mEq/L) in chronic renal failure patients undergoing hemodialysis.

Reference

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