The Japanese Journal of Clinical Dialysis Vol.14 No.13(3)

Theme Ocular Disease in Hemodialysis Patients
Title Management of diabetic retinopathy on patient underwent hemodialysis
Publish Date 1998/11
Author Hideyuki Hayashi Department of Ophthalmology School of Medicine, Fukuoka University
[ Summary ] The majority of diabetic patients who have undergone hemodialysis associated diabetic retinopathy, and have a higher incidence of advanced retinopathy compared with the non-hemodialysed diabetic population. The basic principle of opthalmological management for diabetic patients is preventing irreversible retinal damage. Therefore, all diabetic patients must have their fundus checked by a specialist, even if they have no ocular complications. The proliferative type of diabetic retinopathy, displaying retinal neovascularization,should be treated immediately,using extensive retinal photocoagulation.Pars plana vitrectomy should be considered for patients suffering vitreous hemorrhaging and retinal detachment, instead of retinal photocoagulation. There is no significant difference in the surgical outcome from vitrectomy for treating hemodialysed diabetic patients as compared to non-hemodialysis patients. However, early on after vitrectomy with intraocular gas injection a strict prone position must be maintained to prevent glaucoma.
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