Management of intraocular pressure elevation during hemodialysis of neovascular glaucoma: a case report

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Abstract

Background

It is generally accepted that dialysis may lower plasma osmolality at a faster rate than changes in ocular osmolality. This osmotic difference causes water to migrate from the plasma into the aqueous humor, increasing intraocular pressure. Certain authors have described IOP increase in patients with narrow angles.

Case presentation

Here we report a neovascular glaucoma patient who experienced a substantial increase in IOP associated with severe eye pain and blurred vision during sessions of dialysis. The patient had been refractory to several antiglaucoma drugs and improved after intravenous administration of 20 % hyperosmotic glucose solution with dialysis and pan-retinal photocoagulation.

Conclusion

It is the first report in which intravenous glucose administration and reduction of neovascularization by argon laser pan-retinal photocoagulation successfully managed IOP increase during dialysis in neovascular glaucoma. Further clinical studies are required to confirm our results.

Related collections

Most cited references 25

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Ocular abnormalities associated with advanced kidney disease and hemodialysis.

Ryan D Evans, Mitchell H Rosner (2015)

Patients undergoing chronic hemodialysis (HD) are subject to the unique effects of both uremia and the dialysis procedure on multiple organ systems. Many patients on chronic HD suffer from chronic eye diseases, such as diabetic retinopathy and glaucoma, and the interaction of these diseases with the dialysis procedure can lead to worsening of vision. This review focuses on the common eye diseases seen in patients undergoing chronic HD and how the dialysis procedure and the uremic state impact the visual system.

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Intraocular pressure during haemodialysis: a review.

Benjamin J Levy, Z Tessler, M Zlotnik … (2005)

Although several works in the past have examined the effect of haemodialysis (HD) on intraocular pressure (IOP), reported findings, theories, and conclusions are very different. The objectives of this article are to resume the reported evidence of IOP changes during HD, to review the proposed hypothesis of HD influence on IOP, and to determine if ophthalmic examination is imperative in HD patients. We analysed the peer-reviewed English literature and selected all possible relevant articles. The influence of HD on IOP is not clear, and even in recent studies opposite findings can be found. Future studies are needed to clarify the effects of HD on IOP. In patients with glaucoma or with predisposed narrow angles, or eyes with impaired aqueous outflow, the possibility of acute IOP rise during HD could be much more frequent than in normal patients. So in these patients, a more strict ophthalmic scheduled examination seems to be feasible.

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Surgical results of Ahmed valve implantation with intraoperative bevacizumab injection in patients with neovascular glaucoma.

Kyoung Ma, Jong Yun Yang, Ji Hyun Kim … (2024)

To investigate the surgical results of Ahmed valve implantation with intraoperative bevacizumab injection in patients with neovascular glaucoma (NVG).

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Author and article information

Contributors

P. Frezzotti: +39 0577 41592 , paolofrezzotti@paolofrezzotti.it

Journal

Journal ID (nlm-ta): BMC Ophthalmol

Journal ID (iso-abbrev): BMC Ophthalmol

Title: BMC Ophthalmology

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2415

Publication date (Electronic): 5 March 2016

Publication date PMC-release: 5 March 2016

Publication date Collection: 2016

Volume: 16

Electronic Location Identifier: 23

Affiliations

Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci s.n.c., 53100 Siena, Italy

Article

Publisher ID: 199

DOI: 10.1186/s12886-016-0199-z

PMC ID: 4779209

PubMed ID: 26944556

SO-VID: 088de074-3319-4768-a68f-cce262a792d1

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.