Recurrent symptomatic intraocular pressure spikes during hemodialysis in a patient with unilateral anterior uveitis

Title
Recurrent symptomatic intraocular pressure spikes during hemodialysis in a patient with unilateral anterior uveitis
Author(s)
차순철임수호손준혁
Keywords
GLAUCOMA; ELEVATION
Issue Date
201302
Publisher
BIOMED CENTRAL LTD
Citation
BMC OPHTHALMOLOGY, v.13
Abstract
Background: The relationship between intraocular pressure (IOP) changes and hemodialysis has been evaluated for several decades. However, no report on an IOP rise in uveitis patients during hemodialysis has been previously documented. This report describes the case of an uveitis patient with repetitive IOP spikes associated with severe ocular pain during hemodialysis sessions, which resolved after glaucoma filtering surgery. Case presentation: A 47-year-old male with diabetes and hypertension had complained of recurrent ocular pain in the left eye during hemodialysis sessions. A slit-lamp examination showed diffuse corneal epithelial edema with several white keratic precipitates and inflammatory cells (Grade 3+) in the anterior chamber of the left eye. No visible neovascularization or synechiae were visible on the iris or angle. Topical glaucoma eye-drops and intravenous mannitol before hemodialysis did not prevent subsequent painful IOP spikes in the left eye. At the end of hemodialysis, IOP averaged similar to 40 mmHg. After trabeculectomy with mitomycin C in the left eye, his IOP stabilized in the low-teens (range, 10-14 mmHg) and no painful IOP spikes occurred during hemodialysis over the first postoperative year. Conclusion: We present a case of recurrent painful IOP spikes during hemodialysis in a patient with unilateral anterior uveitis unresponsive to conventional medical treatment prior to hemodialysis. To our knowledge, this is the first case report of repetitive symptomatic IOP rise during hemodialysis in an uveitic glaucoma patient. This case highlights the importance of the awareness of the possibility that IOP may rise intolerably during hemodialysis in uveitis patients with a compromised outflow facility.
URI
http://hdl.handle.net/YU.REPOSITORY/26490http://dx.doi.org/10.1186/1471-2415-13-3
ISSN
1471-2415
Appears in Collections:
의과대학 > 안과학교실 > Articles
의과대학 > 영상의학과학교실 > Articles
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