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      Anterior chamber depth during hemodialysis

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          Abstract

          Background

          Exacerbation of chronic glaucoma or acute glaucoma is occasionally observed in patients undergoing hemodialysis (HD) because of anterior chamber depth changes during this therapy.

          Purpose

          To evaluate anterior chamber depth and axial length in patients during HD sessions.

          Methods

          A total of 67 eyes of 35 patients were prospectively enrolled. Axial length and anterior chamber depth were measured using ultrasonic biometry, and these measures were evaluated at three different times during HD sessions. Body weight and blood pressure pre- and post-HD were also measured.

          Results

          There was no difference in the axial length between the three measurements ( P = 0.241). We observed a significantly decreased anterior chamber depth ( P = 0.002) during HD sessions.

          Conclusion

          Our results support the idea that there is a change in anterior chamber depth in HD sessions.

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          Most cited references21

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          Angle-closure glaucoma: the role of the lens in the pathogenesis, prevention, and treatment.

          Pamela Tarongoy, Ching Ho, David Walton (2009)
          Primary angle-closure glaucoma is a major cause of blindness worldwide. It is a disease of ocular anatomy that is related to pupillary-block and angle-crowding mechanisms of filtration angle closure. Eyes at increased risk for primary angle-closure are small with decreased axial length, anterior chamber depth, and filtration angle width, associated with a proportionately large lens. Angle-closure glaucoma afflicts Asian and Eskimo eyes more frequently than eyes in other races with similar predisposing dimensions. The treatment of primary angle closure addresses its causal mechanisms. Laser peripheral iridotomy equalizes the anterior and posterior pressures and widens the filtration angle by reducing the effect of pupillary block. Argon laser peripheral iridoplasty contracts the iris stroma to reduce angle crowding and is helpful for some affected eyes. Lensectomy dramatically widens the angle and eliminates pupillary block. Clinical reports of lensectomy with posterior chamber intraocular lens implantation in the treatment of acute, chronic, and secondary angle-closure glaucoma describe very favorable results. The appropriate role for lensectomy in the management of primary angle closure, however, remains unproven. Prospective, randomized clinical trials are ongoing to determine the value and comparative risks and efficacy of lensectomy versus medical therapy, laser peripheral iridotomy, laser iridoplasty, and filtration procedures for the treatment of acute and chronic primary angle closure and for the prevention of chronic angle-closure glaucoma, both after and in place of laser peripheral iridotomy.
          Article 0 comments Cited 54 times – based on 0 reviews     Review now
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            The prevalence of primary angle closure glaucoma in European derived populations: a systematic review.

            Alexander Day, Gianluca Baio, Gus Gazzard … (2012)
            To estimate the prevalence of primary angle closure glaucoma (PACG) in European derived populations. Systematic review and modelling of PACG prevalence data from population studies. PACG was defined according to the ISGEO definition requiring structural and/or functional evidence of glaucomatous optic neuropathy. Prevalence estimates were applied to the 2010 United Nations projected population figures to estimate case numbers. The prevalence of PACG in those 40 years or more is 0.4% (95% CI 0.3% to 0.5%). Age-specific prevalence values are 0.02% (CI 0.00 to 0.08) for those 40-49 years, 0.60% (0.27 to 1.00) for those 50-59 years, 0.20% (0.06 to 0.42) for those 60-69 years and 0.94% (0.63 to 1.35) for those 70 years and older. Three-quarters of all cases occur in female subjects (3.25 female to 1 male; CI 1.76 to 5.94). This analysis provides a current evidence-based estimate of PACG prevalence in European derived populations and suggests there are 130,000 people in the UK, 1.60 million people in Europe and 581,000 people in the USA with PACG today. Accounting for ageing population structures, cases are predicted to increase by 19% in the UK, 9% in Europe and 18% in the USA within the next decade. PACG is more common than previously thought, and all primary glaucoma cases should be considered to be PACG until the anterior chamber angle is shown to be open on gonioscopy.
            Article 0 comments Cited 49 times – based on 0 reviews     Review now
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              Angle closure glaucoma: a mechanistic review.

              Judy Y F Ku, Monisha E. Nongpiur, Tin Aung (2011)
              With recent advances in imaging techniques such as anterior segment optical coherence tomography and ultrasound biomicroscopy, there is a better understanding of nonpupil block mechanisms and novel risk factors contributing to the pathogenesis of angle closure glaucoma. Recent studies suggest that multiple anatomical and physiological factors interplay in the pathogenesis of angle closure glaucoma. The association of greater iris convexity, area and thickness with narrow angles could result in a more anterior bowing and crowding of the peripheral iris. Other novel anatomic parameters such as greater lens vault, smaller anterior chamber width, area and volume, independently increase the risk of having angle closure. Dynamic increase or lesser reduction in iris volume during dilation supports the theory of physiological predisposition to the disease process. Choroidal expansion has been demonstrated in untreated and treated, acute and chronic primary angle closure eyes. It remains unknown whether this finding is a cause or effect in this condition. With a wider availability of imaging tools and a better understanding of risk factors and mechanisms, clinicians maybe able to more accurately identify those at greater risk of developing angle closure disease and tailor their treatment according to the predominant factor(s) involved.
              Article 0 comments Cited 47 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Ophthalmol
                Journal ID (iso-abbrev): Clin Ophthalmol
                Journal ID (publisher-id): Clinical Ophthalmology
                Title: Clinical Ophthalmology (Auckland, N.Z.)
                Publisher: Dove Medical Press
                ISSN (Print): 1177-5467
                ISSN (Electronic): 1177-5483
                Publication date Collection: 2013
                Publication date (Print): 2013
                Publication date (Electronic): 12 August 2013
                Volume: 7
                Pages: 1635-1639
                Affiliations
                [1 ]Ophthalmology Department, University of São Paulo - UNIFESP, São Paulo, Brazil
                [2 ]Division of Nephrology, Federal University of São Paulo - UNIFESP, São Paulo, Brazil
                Author notes
                Correspondence: Carolina Pelegrini, Barbosa Gracitelli Federal University of São Paulo (UNIFESP/EPM), 821 Botucatu Street, Vila Clementino, São Paulo 04023-062, Brazil, Tel +55 11 5085 2010, Fax +55 11 5085 2000, Email carolepm@ 123456gmail.com
                Article
                Publisher ID: opth-7-1635
                DOI: 10.2147/OPTH.S45952
                PMC ID: 3747119
                PubMed ID: 23976841
                SO-VID: a63a7738-a94b-489b-8fdc-3b1312cdd50a
                Copyright © © 2013 Gracitelli et al, publisher and licensee Dove Medical Press Ltd
                License:

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                Categories
                Subject: Original Research

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: anterior chamber,hemodialysis,axial length,acute angle-closure glaucoma
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: anterior chamber, hemodialysis, axial length, acute angle-closure glaucoma

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