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Perspective - Journal of Clinical Nephrology and Therapeutics (2021) Volume 5, Issue 6
Recovery of vision after treatment of hemodialysis related bilateral optic nerve ischemia
Hypotension is the most frequent complication of hemodialysis, being in 10–50 of the sessions and it's a significant cause of morbidity and mortality in this group of cases. There are some mechanisms described, the most important is due to a rapid-fire reduction in blood volume during the ultrafiltration. To our knowledge, in the literature, since 1986 lower than 30 cases of nonarteritic anterior ischemic optical neuropathy as a result of dialysis convinced hypotension had been described. The visual consequences are still inadequately recognized. We report this case to draw attention to the visual complaints potentially unrecoverable in this threat group. Cases with habitual order complaint frequently also present with anemia and hypertension, conferring lesser vulnerability to ischemic lesions in the optical discs. NAAION started by hypotension is described in literature and it's allowed that nightly hypotension is the medium behind the high number of NAAION cases during the sleep period. Considering that the immunological and serological study was negative and adding to the known threat factors for NAAION the relative hypotension during de dialysis session that coincided with visual complaints leads us to explosively consider the thesis of NAAION convinced by dialysis hypotension.
Author(s): Debbie Nomiko