Choroidal Thickness Evaluation Before and After Hemodialysis in Patients With and Without Diabetes

PURPOSE. We evaluated the effect of hemodialysis on the choroidal thickness in patients with and without diabetes who have end-stage kidney disease (ESKD). METHODS. Forty-one patients with ESKD were recruited and divided into two groups: those with ESKD due to diabetic nephropathy (DM group, 37 eyes of 20 patients) and those with nondiabetic ESKD (NDM group, 40 eyes of 21 patients). Using spectral-domain optical coherence tomography (SD-OCT), the subfoveal choroidal thickness (SCT) was measured before and after hemodialysis, and the change ratio (DSCT [%]) was calculated. RESULTS. The SCT decreased in all eyes after hemodialysis. The DSCT value in the DM group (� 12.6 6 2.7%) was significantly (P ¼ 0.00027) larger than that in the NDM group (� 6.9 6 2.3%). Moreover, the DSCT per body fluid removal (BFR [L]) in the DM group was significantly (P ¼ 0.013) greater than in the NDM group. In the DM group, the mean DSCT in the eyes treated with panretinal photocoagulation (PRP; n ¼ 19) was significantly (P ¼ 0.035) larger than that in eyes not treated with PRP (n ¼ 18). The relationship between the DSCT and BFR was not significant (R 2 ¼ 0.0038, P ¼ 0.80) in the DM group but was significant (R 2 ¼ 0.54, P ¼ 0.00013) in the NDM group. CONCLUSIONS. The current results may reflect that systemic fluid accumulation has a greater effect on the diabetic choroid, probably due to damage to the choroidal vasculature, in patients with ESKD.