Introduction: The vessel calibres of retinal arterioles decreased progressively with each chronic kidney disease stage of renal failure, suggesting that progression of renal dysfunction might be associated with retinal vessel constriction. Retinal microvascular abnormalities are common in chronic kidney disease because hypertension, renovascular disease, and diabetes account for more than half of all patients with renal failure.

Material and Methods: Total 128 patients having end stage chronic kidney disease on maintenance haemodialysis were examined. Patients of chronic kidney disease on maintenance hemodialysis were included and cases of reversible kidney injury were excluded. Direct and Indirect ophthalmoscopy along with history and examination was done.

Results: Total 128 patients, 96 (75%) male and 36 (25%) female were included. Male to female ratio was 4:1.Mean age of patients was 34.55±12.98 years with minimum age of 8 years and maximum age of 76 years. Most of the patients belong to age group 31-40 years. Minimum duration from initiation of dialysis therapy was 6 months and maximum duration was 9 years with average duration of 2.61±1.75 years. Most common fundus change was mild retinopathy found in 60 (46.88%) patients followed by moderate retinopathy found in 18 (14.06%) patients followed by severe retinopathy found in 8 (6.25%) patients. However fundus was normal in 42 (32.81%) patients. Most common type of retinopathy was hypertensive retinopathy found in 39 (30.47%) patients followed by mixed type of retinopathy 31 (24.22%) patients, diabetic retinopathy 12 (9.38%) patients, papilloedema found in 3 (2.34%) patients, macular oedema found in 1 (0.78%) patient. However no retinopathy found in 42 (32.81%) patients.

Conclusion: Hypertensive retinopathy was the most common type of retinopathy found in haemodialysis patients followed by mixed retinopathy, diabetic retinopathy, papilloedema and macular oedema. However no retinopathy found in about 1/3 of patients. In haemodialysis patients with retinopathy, majority had mild retinopathy.

Keywords: Fundus changes, Haemodialysis, Retinopathy, Papilloedema.

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Dr Vivek Kumar Verma

Lecturer, Dept of General Medicine, U.P. University of Medical Sciences, Saifai, Etawah, India 206130

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