Perbedaan Ketebalan Retinal Nerve Fiber Layer (RNFL) dan Makula Sebelum dan Sesudah Terapi Hemodialisa pada Penderita End Stage Renal Disease (ESRD) di Rumah Sakit Prof Dr Chairuddin P Lubis

Abstract

Background : End Stage Renal Disease (ESRD) is the end condition of Chronic Kidney Disease (CKD) which causes many complications, including in the eye. Hemodialysis can trigger Optic Neuropathy which is diagnosed through Optical Coherence Tomography (OCT) to see the thickness of the Retinal Nerve Fiber Layer (RNFL) and Macula. Method: This study was conducted analytically observative with a prospective cohort design on all hemodialysis patients by non-probability consecutive sampling at the Eye Polyclinic, Department of Vitero-Retina at the University of North Sumatra Hospital starting in February 2023. The number of samples is 16 patients who will be followed before and after undergoing hemodialysis. Target age over 40 years and sign informed consent. Results : We found a larger sample of men (56.3%), mean age 52.5 years, significant difference (p<0.001) in RNFL before hemodialysis and after hemodialysis. However, after the first week of hemodialysis, there was an association except for the average measurement of RNFL OD (p = 0.098) and inferior RNFL OS (p = 0.211). In the macula there was a significant association in the patient's OS fovea macula before hemodialysis and after hemodialysis (p<0.001), up to a strong association 1 week after hemodialysis (p = 0.004). In general, there is a thickening of the macula that still takes place within 1 week after hemodialysis in both eyes. Conclusion: From this study, we found a relationship between hemodialysis action on morphological changes in the eye, especially in the RNFL and Macular variables we tested. However, there are changes in results that might be improved after 1 week of the first hemodialysis performed, we open opportunities for futher research into risk factors and protective factors that affect morphological manifestations in the eye.