الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Chronic kidney disease is a global public health problem and diabetes is a leading cause for it. Those patients with ESRD are generally treated using hemodialysis. HD causes numerous metabolic changes which in turn induce osmotic changes in blood and extracellular fluids including the aqueous and vitreous humor, so there are many ocular abnormalities in ESRD patients either due to common pathophysiological mechanisms and risk factors between eye and kidney diseases or due to hemodialysis itself.
Our current study was carried out on 44 eyes of 23 patients, with chronic kidney disease on regular hemodialysis for duration of 2-10 years in the Dialysis unit at Agouza Specialized Hospital. All our cases were evaluated ophthalmologically after their dialysis sessions.
Diabetes mellitus was the most prevalent cause of
CKD in our study followed by HTN.
As regard the ocular findings in CRF patients on HD included in our study; most of eyes had good vision more than 6/18. Other patients had impaired vision and this was mainly due to cataract followed by PDR and DME. In our study, IOP was within normal range but there was statistically difference among those who had DM, HTN and neither as regard the mean IOP.
In our work, abnormal anterior segment findings were consistent in the form of yellow sclera as the most
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Summary &Conclusion
prevalent anterior finding followed by cataract, lid edema and dry eye, there was no statistically significant difference between diabetic, hypertensive and others as regard these findings.
Regarding conjunctiva, there was statistically significant difference between diabetic, hypertensive and others as regard conjunctival congestion, pterygium and PTDs. Also we found nebula in one eye and IOL.
In our study, posterior segment findings were the most visual threatening signs; diabetic retinopathy was the commonest finding in all diabetic patients, presented in NPDR, PDR, CSME. Hypertensive retinopathy, age related macular degeneration and macular hemorrhage also were found. These findings were further studied and assessed by SD-OCT.
Using SD-OCT, we had an idea about macular thickness through macular thickness mapping, there was statistically significant difference between eyes of diabetic, hypertensive and other patients as regard central foveal thickness (CFT), Mean CFT in eyes of diabetic patients was the highest due to diabetic macular edema followed by HTN, but there was reduction in other patients presented by color coding.
Conclusion:
Our results demonstrate high prevalence of abnormal ocular findings in chronic renal failure patients on hemodialysis as regard vision, anterior and posterior
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Summary &Conclusion
segments abnormalities which need close follow up to those patients on chronic hemodialysis by the ophthalmologist.
Study Limitations:
The current study has got important limitations that should be considered before drawing solid conclusions from its results, namely, the small sample of studied patients, absence of controls and the lack of prospective design to compare acute changes before and after HD.