Impact of Hemodialysis on Subfoveal Choroidal Thickness Measured by Optical Coherence Tomography: A Systematic Review and a Pooled Analysis of Self-Controlled Case Series
Abstract Introduction Hemodialysis (HD) has various effects on the body, including optimizing body fluid composition and volume, which may have an impact on subfoveal choroidal thickness (SCT) in individuals with end-stage kidney disease (ESKD). However, previous studies have produced conflicting re...
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2023-07-01
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| Series: | Ophthalmology and Therapy |
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| Online Access: | https://doi.org/10.1007/s40123-023-00761-6 |
| _version_ | 1797736445853564928 |
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| author | Zixuan Su Yamin Mao Zhiyi Qi Meng Xie Xueqing Liang Banghuan Hu Xinghua Wang Fagang Jiang |
| author_facet | Zixuan Su Yamin Mao Zhiyi Qi Meng Xie Xueqing Liang Banghuan Hu Xinghua Wang Fagang Jiang |
| author_sort | Zixuan Su |
| collection | DOAJ |
| description | Abstract Introduction Hemodialysis (HD) has various effects on the body, including optimizing body fluid composition and volume, which may have an impact on subfoveal choroidal thickness (SCT) in individuals with end-stage kidney disease (ESKD). However, previous studies have produced conflicting results regarding the effect of HD on SCT in patients with ESKD. Therefore, we conducted a meta-analysis to investigate the influence of HD on SCT. Methods A comprehensive search of relevant studies and bibliographies was conducted using Embase, PubMed, and Web of Science databases up to September 2022. Weighted mean difference (WMD) and 95% confidence interval (CI) were used to summarize the SCT change. Heterogeneity and publication bias were assessed, and a random-effects model was employed for the meta-analysis. Subgroup analyses were also performed to evaluate the influence of factors such as diabetes mellitus (DM), the severity of diabetic retinopathy (DR), diurnal variation adjustment, optical coherence tomography (OCT) types, and OCT scan modes. Results A total of 15 studies involving 1010 eyes were eligible for this meta-analysis, including 552 diabetic eyes, 230 non-diabetic eyes, and the remaining 228 eyes were uncategorized. The meta-analysis revealed a significant reduction in SCT after HD (WMD = −13.66 μm; 95% CI −24.29 to −3.03 μm; z = −5.115, P < 0.0001). Subgroup analysis indicated a significant difference between the DM and non-DM groups (WMD = −24.10 μm vs. −15.37 μm, 95% CI −27.39 to −20.80 μm vs. −19.07 to −11.66 μm; P = 0.001). Additionally, the group with proliferative diabetic retinopathy (PDR) exhibited a more pronounced reduction in SCT (WMD = −28.66 μm; 95% CI −37.10 to −20.23; z = −6.660, P < 0.0001). Adjusting for diurnal variation, different types or scan modes of OCT did not significantly affect the results. Conclusion HD leads to a significant decrease in SCT among patients with ESKD, especially in patients with DM with PDR. |
| first_indexed | 2024-03-12T13:14:02Z |
| format | Article |
| id | doaj.art-f3d90b108d03476c89abfb1c32b694d3 |
| institution | Directory Open Access Journal |
| issn | 2193-8245 2193-6528 |
| language | English |
| last_indexed | 2024-03-12T13:14:02Z |
| publishDate | 2023-07-01 |
| publisher | Adis, Springer Healthcare |
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| series | Ophthalmology and Therapy |
| spelling | doaj.art-f3d90b108d03476c89abfb1c32b694d32023-08-27T11:11:48ZengAdis, Springer HealthcareOphthalmology and Therapy2193-82452193-65282023-07-011252265228010.1007/s40123-023-00761-6Impact of Hemodialysis on Subfoveal Choroidal Thickness Measured by Optical Coherence Tomography: A Systematic Review and a Pooled Analysis of Self-Controlled Case SeriesZixuan Su0Yamin Mao1Zhiyi Qi2Meng Xie3Xueqing Liang4Banghuan Hu5Xinghua Wang6Fagang Jiang7Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Biostatistics, School of Public Health, Southern Medical UniversityDepartment of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Introduction Hemodialysis (HD) has various effects on the body, including optimizing body fluid composition and volume, which may have an impact on subfoveal choroidal thickness (SCT) in individuals with end-stage kidney disease (ESKD). However, previous studies have produced conflicting results regarding the effect of HD on SCT in patients with ESKD. Therefore, we conducted a meta-analysis to investigate the influence of HD on SCT. Methods A comprehensive search of relevant studies and bibliographies was conducted using Embase, PubMed, and Web of Science databases up to September 2022. Weighted mean difference (WMD) and 95% confidence interval (CI) were used to summarize the SCT change. Heterogeneity and publication bias were assessed, and a random-effects model was employed for the meta-analysis. Subgroup analyses were also performed to evaluate the influence of factors such as diabetes mellitus (DM), the severity of diabetic retinopathy (DR), diurnal variation adjustment, optical coherence tomography (OCT) types, and OCT scan modes. Results A total of 15 studies involving 1010 eyes were eligible for this meta-analysis, including 552 diabetic eyes, 230 non-diabetic eyes, and the remaining 228 eyes were uncategorized. The meta-analysis revealed a significant reduction in SCT after HD (WMD = −13.66 μm; 95% CI −24.29 to −3.03 μm; z = −5.115, P < 0.0001). Subgroup analysis indicated a significant difference between the DM and non-DM groups (WMD = −24.10 μm vs. −15.37 μm, 95% CI −27.39 to −20.80 μm vs. −19.07 to −11.66 μm; P = 0.001). Additionally, the group with proliferative diabetic retinopathy (PDR) exhibited a more pronounced reduction in SCT (WMD = −28.66 μm; 95% CI −37.10 to −20.23; z = −6.660, P < 0.0001). Adjusting for diurnal variation, different types or scan modes of OCT did not significantly affect the results. Conclusion HD leads to a significant decrease in SCT among patients with ESKD, especially in patients with DM with PDR.https://doi.org/10.1007/s40123-023-00761-6End-stage kidney diseaseDiabetes mellitusDiabetic retinopathySubfoveal choroidal thicknessHemodialysisOptical coherence tomography |
| spellingShingle | Zixuan Su Yamin Mao Zhiyi Qi Meng Xie Xueqing Liang Banghuan Hu Xinghua Wang Fagang Jiang Impact of Hemodialysis on Subfoveal Choroidal Thickness Measured by Optical Coherence Tomography: A Systematic Review and a Pooled Analysis of Self-Controlled Case Series Ophthalmology and Therapy End-stage kidney disease Diabetes mellitus Diabetic retinopathy Subfoveal choroidal thickness Hemodialysis Optical coherence tomography |
| title | Impact of Hemodialysis on Subfoveal Choroidal Thickness Measured by Optical Coherence Tomography: A Systematic Review and a Pooled Analysis of Self-Controlled Case Series |
| title_full | Impact of Hemodialysis on Subfoveal Choroidal Thickness Measured by Optical Coherence Tomography: A Systematic Review and a Pooled Analysis of Self-Controlled Case Series |
| title_fullStr | Impact of Hemodialysis on Subfoveal Choroidal Thickness Measured by Optical Coherence Tomography: A Systematic Review and a Pooled Analysis of Self-Controlled Case Series |
| title_full_unstemmed | Impact of Hemodialysis on Subfoveal Choroidal Thickness Measured by Optical Coherence Tomography: A Systematic Review and a Pooled Analysis of Self-Controlled Case Series |
| title_short | Impact of Hemodialysis on Subfoveal Choroidal Thickness Measured by Optical Coherence Tomography: A Systematic Review and a Pooled Analysis of Self-Controlled Case Series |
| title_sort | impact of hemodialysis on subfoveal choroidal thickness measured by optical coherence tomography a systematic review and a pooled analysis of self controlled case series |
| topic | End-stage kidney disease Diabetes mellitus Diabetic retinopathy Subfoveal choroidal thickness Hemodialysis Optical coherence tomography |
| url | https://doi.org/10.1007/s40123-023-00761-6 |
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