Kocaeli Med J. 2021; 10(1): 147-153 | DOI: 10.5505/ktd.2021.62548

Evalulation of Optical Coherence Tomography Measurements in Peritoneal Dialysis Patients

Sibel Bek¹, Adnan Batman², Necmi Eren¹, Büþra Yýlmaz Tuðan³, Serkan Bakirdogen^4
1Kocaeli University Hospital, Nephrology, Kocaeli
²Kocaeli University Hospital, Internal Medicine, Kocaeli
³Kocaeli University Hospital, Ophthalmology, Kocaeli
⁴18 Mart Canakkale University Hospital, Nephrology,Canakkale

INTRODUCTION: Optical coherence tomography (OCT) is a non-invasive ocular imaging technique widely used nowadays. There are limited studies focusing on the OCT findings in PD patients. Our aim is to compare retinal changes of peritoneal dialysis (PD) patients with healthy control group by using OCT and investigate the effects of age, gender and duration of PD on these parameters.
METHODS: In this cross-sectional study right and left eyes of 32 patients and twenty right and left eyes of ten healthy controls were included. Detailed ophthalmological examinations with central macular thickness (CMT), peripapillary retinal nerve fiber layer (RNFL) thickness, and choroidal thickness (using EDI-OCT) were measured. Macular thickness was measured at five different areas: central,superior, temporal, inferior and nasal. The peripapillary RNFL thickness was analysed in six different areas: temporal, inferotemporal, inferonasal, nasal, superonasal and superotemporal.
RESULTS: Sixty-four eyes of 32 patients (18 males, 14 females; aged 20 to 60 years, mean 48.67±12.25 years) with a mean duration of PD of 46.80 months were included. There was a significant difference of macular thickness in the central, temporal, nasal, inferior and superior quadrants between controls and PD patients (p < 0.05). Vitamin D3 supplementation was linked to decreased macular thickness in central, temporal, superior, nasal and inferior quadrants (p<0.05). There was a positive correlation between macular thickness in central and temporal quadrants with residual renal function (p=0.006, p=0.019).
DISCUSSION AND CONCLUSION: OCT revealed a significant reduction of macular thickness in all quadrants in PD patients.

Keywords: Optical coherence tomography, peritoneal dialysis, vitamin D

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Periton Diyalizi Hastalarýnda Optik Koherens Tomografi Ölçümlerinin Deðerlendirilmesi

Sibel Bek¹, Adnan Batman², Necmi Eren¹, Büþra Yýlmaz Tuðan³, Serkan Bakirdogen^4
1Kocaeli Universitesi Tip Fakultesi, Nefroloji Bilim Dali, Kocaeli, Türkiye
²Kocaeli Universitesi Tip Fakultesi, Ic Hastaliklari Anabilim Dali, Kocaeli, Türkiye
³Kocaeli Universitesi Tip Fakultesi, Goz Hastaliklari Anabilim Dali, Kocaeli, Türkiye
⁴18 Mart Canakkale Universitesi Hastanesi, Nefroloji Bilim Dali, Canakkale, Türkiye

GÝRÝÞ ve AMAÇ: OCT(Optik koherens tomografi), günümüzde yaygýn olarak kullanýlan non-invaziv bir oküler görüntüleme tekniðidir. PD hastalarinda OCT bulgularinin deðerlendirildiði sýnýrlý sayýda çalýþma vardýr. Bu calismada amacýmýz optik koherens tomografi (OKT) ile periton diyalizi (PD) hastalarýnýn retina deðiþikliklerini saðlýklý kontrol grubu ile karþýlaþtýrmak ve PD'nin yaþ, cinsiyet ve süresinin bu parametrelere etkisinin araþtýrýlmasýdir
YÖNTEM ve GEREÇLER: Bu kesitsel çalýþmaya 32 hastanýn sað ve sol gözü ve 10 saðlýklý kontrolün yirmi sað ve sol gözü deðerlendirildi. Santral maküla kalýnlýðý (CMT), peripapiller retina sinir lifi tabakasý (RSLT) kalýnlýðý ve koroid kalýnlýðý (EDI-OCT kullanýlarak) ile detaylý oftalmolojik muayeneler ölçüldü. Makula kalýnlýðý beþ farklý alanda ölçüldü: merkezi, üst, temporal, alt ve nazal. Peripapiller RSLT kalýnlýðý altý farklý alanda (temporal, inferotemporal, inferonasal, nazal, superiornasal ve superiortemporal) analiz edildi.
BULGULAR: Ortalama PD süresi 46,80 ay olan 32 hastanýn (18 erkek, 14 kadýn; 20-60 yaþ, ortalama 48,67 ± 12,25 yýl) 64 gözü çalýþmaya alýndý. Kontroller ve PD hastalarý arasýnda santral, temporal, nazal, inferior ve superior kadranlarda maküla kalýnlýðý açýsýndan anlamlý farklýlýk vardý (p <0.05). D3 vitamini takviyesi, santral, temporal, üst, nazal ve alt kadranlarda maküla kalýnlýðýnýn azalmasý ile baðlantýlý bulundu (p <0.05). Rezidüel renal fonksiyon ile santral ve temporal kadranlarda maküla kalýnlýðý arasýnda pozitif korelasyon goruldu (p = 0,006, p = 0,019).
TARTIÞMA ve SONUÇ: PD hastalarýnda OCT tum kadranlarda retina kalýnlýðýnda incelme tespit edilmiþtir.

Anahtar Kelimeler: Optical coherence tomography, peritoneal dialysis, vitamin D

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