Ocular lesions in melanodermia patients with chronic renal failure

AIM: To describe the and the factors that influence their occurrence. MATERIAL AND METHODS: A prospective study was performed over a year in the Ophthalmology clinic of Aristide le DANTEC Hospital, including 112 eyes of chronic renal failure patients followed up in the internal medicine unit of the same hospital. For each patient data of his follow up in the nephrology ward were recorded, even as the ophthalmological clinical examination which included colour test and angiography. All the lesions found were recorded on a questionnaire, seeking for any influence as far as age, sex, duration of signs, dialysis, and general complications were concerned. The analysis was performed using the 2005 Epi-info 6.0 software. RESULTS: Sex ratio was 1.54. 70% were above 40 years old. Blindness was found on 44.6% of the eyes. There were 20.5% cases of eye lids oedema, 15.8% conjunctival calcifications, 26.8% cataracts, 3 cases of ocular hypertension, 7.1% corneal lesions. Hypertensive retinopathy was found on 75.9% of the cases, amongst 14.3% classified stage 3, and retinal oedema signs associated on 13.8%, arteriosclerosis on 14.3% of the cases. 88.1% had confirmed signs of dyschromatopsia. On angiography, there was evidence of chorioretinal lesions due to high blood pressure, including decrease of the choroidal blood flow, choroidal ischemic areas, and halo peripapillary oedema. Age was a risk factor for eye lid oedema. Corneal and conjunctival lesions, even as eye lid oedema and hypertensive retinopathy were more frequent on patients, sick for less than a year. High blood pressure was a risk factor for papillary lesions, hypertensive retinopathy, and dyschromatopsia. Corneal and conjunctival calcifications were found mostly on patients on dialysis, whereas they had less eye lid oedema, hypertensive retinopathy, and maculopathy. CONCLUSION: Retinal lesion, especially due to high blood pressure is the most described. It permits to establish the prognostic of the disease. Patients on dialysis show a decrease of that retinopathy, but some sequels might persist which are invalidating, irreversible and may lead to blindness. This can be prevented by early screening of high blood pressure and an adequate treatment of chronic renal failure. Ophthalmologic examination remains a cheap and simple method to prevent the complications.