PATTERN OF RETINOPATHY AMONG PATIENTS ON HEMODIALYSIS, SAINT PAUL HOSPITAL MILLENNIUM MEDICAL COLLEGE ADISS ABABA, ETHIOPIA.

Abstract

Abstract Background: Retinopathy is any of various non-inflammatory disorders affecting the retina marked by damage to retinal blood vessels, retinal swelling or abnormal growth of new blood vessels. The type of retinopathy is often specified as arteriosclerotic or hypertensive retinopathy. A pathophysiological mechanism of hemodialysis related retinopathy could be associated with cause of end stage renal disease or treatment related. The major causes of end stage renal disease requiring hemodialysis includes diabetes mellitus, hypertension and glomerulonephritis. In Ethiopia unidentified causes, diabetes mellitus, hypertension and glomerulonephritis accounts for majority of end stage renal disease requiring hemodialysis. Objective of the study was to describe pattern of retinopathy among patients on hemodialysis at SPHMMC renal transplant unit from September 2020 to December 2021. Methods: A cross- sectional descriptive hospital based study was undertaken from September 2020 to December 2021 at SPMMC national renal transplant unit center which is located in Addis Ababa. It is one of few public RRT center in the country established in 2014 and was providing hemodialysis for 59 patients during study period. The study was conducted among all 59 patients who had undergone hemodialysis during this period. Ocular, medical and nephrology history was recorded from the patient's chart using checklist. Best correct visual acuity using snellen scale and dilated fundus examination using Slit lamp bio microscopy with noncontact 90 diopter lens and indirect ophthalmoscope was done for presence of retinopathy. Data was entered and analyzed using SPSS version 25.0 after data quality control checking and result was presented with frequency tables and graphs for categorical variables and mean, median and standard deviations were calculated for numeric variables. Association between dependent and independent variables was tested using the chi-square test and P-value < 0.05 was taken as statistically significant association. Result: A total number of 59 case with 118 eyes of chronic kidney disease patients on hemodialysis were analyzed. Out of 59 study cases 35(59.3%) participants were males. Mean age of total patients was 36.9 years with a standard deviation of 11.995 (ranging from 17–72 years) and the male: female ratio was 1.46:1. Most study subjects 35 (59.3 %) were between 20 to 40 years of age. Most study participants 52(88.1 %) were from urban area. The result of this study showed that about 26 (44.1%) of study participants and 52(44.1%) examined eyes from total 59 study subjects and 118 examined eyes undergoing hemodialysis had retinopathy.The most common pattern of retinopathy was hypertensive retinopathy for 35(67.31%) eyes, mixed retinopathy for 12(23.08%) eyes and diabetic retinopathy for 4(7.69%) eyes of retinopathy.This study showed statistically significant association between both history and duration of diabetes, and hypertension and history of ocular screening with presence of retinopathy with p value less than 0.05 with 95% CI. Conclusion This study showed presence of retinopathy among patients undergoing HD was high. HR was the most common pattern of retinopathy followed by mixed retinopathy.