| Theme | Preventive Medical Screening and Health Check-ups for Dialysis patients | |
|---|---|---|
| Title | Screening fundal examination for hemo-dialysis patients | |
| Publish Date | 2009/02 | |
| Author | Kishiko Ohkoshi | Department of Ophthalmology, St. Luke's International Hospital |
| [ Summary ] | Fundal examination is important for preventative health care, not only to screen for specific eye diseases but also to predict cerebrovascular diseases. In Japan, photographic examination without pupillary dilation has been performed to screen for retinal arteriosclerotic changes for several decades. There has been a great deal of evidence which has shown that retinal arteriosclerotic levels correlate with incidence of stroke. The prevalence of these ocular findings is more common in patients receiving hemodialysis. Eighty percent of patients at induction of hemodialysis displayed ocular findings and more advanced arteriosclerotic levels than the general public. Fundal examination for screening of diabetic retinopathy is also important because, there has been strong evidence that laser photocoagulation is effective to prevent blindness if it is performed in a timely fashion. In diabetic patients, therefore, fundal examination is recommended annually regardless of retinopathy stage. Recently, glaucoma has become a leading cause of blindness in Japan. Diagnostic criteria for glaucoma include optic disc cupping which is detectable with fundal screening examinations. Fundal examination as a mode of screening thus seems to be important for patients receiving hemodialysis. However, there has been no evidence to prove the efficacy of this examination for decrease mortality, morbidity, or blindness in hemodialysis patients. Further studies are necessary to assess the efficacy of fundal examinations. |
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