Changes of Ocular Structures After Hemodialysis in Patients With Chronic Kidney Diseases

Study Overview
=================
Brief Summary
-----------------
To evaluate the effect of hemodialysis on various ophthalmologic parameters in patients with end-stage kidney disease (ESRD).

Detailed Description
-----------------
Subjects: patients with ESRD undergoing hemodialysis at the Dialysis Center of Hanyang Guri Hospital Ocular parameters: visual acuity, intraocular pressure, axial length, OCT Other systemic parameters: body weight, ultrafiltration volume, and systolic/diastolic blood pressure All measurements were performed near the dialysis center. Measurements were performed on Monday (for patients who underwent dialysis sessions on Monday, Wednesday, and Friday) or Tuesday (for patients who underwent dialysis sessions on Tuesday, Thursday, and Saturday. All parameters were measured before and after the hemodialysis.

Official Title
-----------------
Changes of Ocular Structures After Hemodialysis in Patients With Chronic Kidney Diseases

Conditions
-----------------
Chronic Kidney Diseases, Hemolysis

Intervention / Treatment
-----------------
* Other: ophthalmologic exams


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: 1) patients who are regularly dialyzed in our dialysis room to participate in the study 2) patients who agree with our study protocol 3) patients who have unstable general condition Exclusion Criteria: 1) previous intraocular surgery, (2) baseline IOP greater than 22 mmHg, (3) presence of glaucomatous optic disc changes including excavation, thinning, or notching of the neuroretinal rim, (4) axial length greater than 26 mm, and (5) combined macular and retinal diseases such as central serous chorioretinopathy and age-related macular degeneration, except diabetic retinopathy.

Ages Eligible for Study
-----------------
Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| patients with chronic kidney diseases<br>patients with end stage retinal disease undergoing hemodialysis underwent various ophthalmologic exams before and after hemodialysis. | Other: ophthalmologic exams<br>* ophthalmologic exams such as vision, intraocular pressure, axial length and optical coherence tomography<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| changes of retinal and choroidal thickness after hemodialysis | retinal & choroidal thickness on OCT | immediately (within 10 minutes) before and after hemodialysis | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| changes of foveal vascular density using optical coherence tomography-angiography (OCTA) after hemodialysis | vessel density on OCTA | immediately (within 10 minutes) before and after hemodialysis | 
| the effect of hemodialysis (HD) on anterior chamber angle by anterior segment optical coherence | intraocular pressure, retinal thickness, anterior chamber angle | immediately (within 10 minutes) before and after hemodialysis |