Evaluation of peripapillary perfusion alterations after haemodialysis using OCT angiography

Author: El Ouafi Bouazzaoui (Tunisia)

Co-authors: Rahma Saidane, Racem Choura, Asma Khallouli, Ahmed Arfaoui, Afef Maalej, Riadh Rannen

Purpose

To assess the peripapillary microvasculature before and after haemodialysis (HD) in end-stage renal disease (ESRD) using Spectral Domain Optical Coherence Tomography Angiography (SD-OCTA).

Setting/Venue

Department of Ophthalmology of the Military Hospital of Tunis, Tunisia.

Methods

Fifteen eyes of 15 patients with ESRD undergoing HD were included. All subjects underwent comprehensive ocular examination and OCTA within 15 min before and after HD session. The systolic blood pressure (SBP), diastolic blood pressure (DBP), body weight and ultrafiltration volume were measured within 5 min before and after HD. OCTA scans were performed using AngioVue software of the Optovue RTVue XR Avanti. A 4.5 × 4.5 mm images for the Radial Peripapillary Capillaries (RPC) were obtained. Retinal Nerve Fiber Layer (RNFL) thickness, whole image (wi), inside disc (id) and peripapillary (pp) were evaluated.

Results

The mean age was 51.88 ± 7.03. The sex ratio was 1.15. There was a significant decrease in body weight and SBP after HD (before :61.4 ± 11.3 kg; after :58.6 ± 11.5 kg; p = 0.011) and SBP (before: 151.8 ± 32.5 mmHg ; after :141.7 ± 29.5 mm Hg ; p= 0.014). All peripapillary vascular densities (wi, id, pp) deceased significantly after HD (all p<0.05). Compared to baseline, there was a thickening of the RNFL after HD session (p=0.02). The reduction in RPC VDs correlated with the decrease in SBP (R=0.654, p=0.02).

Conlusions

OCT-A is a non-invasive imaging modality that may be useful to identify peripapillary vascular network changes associated with systemic vascular diseases. However, further studies are warranted to confirm the mechanism underlying these findings.

Financial Disclosure

The authors declare no conflict of interest.