Major Ocular Abnormalities Among Hemodialysis Patients in Indonesia.

BACKGROUND: This study aimed to identify the major ocular abnormality findings (i.e., cataract and conjunctival and corneal calcification (CCC)) among hemodialysis (HD) patients and their risk factors. METHODS: A single institute-based cross-sectional study in Indonesia. Demographic data, medical histories, and complete ocular examinations were collected. For two major ocular abnormalities found, a generalized estimating equation was incorporated in a logistic regression model to assess the relationship with their risk factors. RESULTS: We analyzed 318 eyes (159 individuals), of which 54.7% male and 45.3% female. The mean age was 51.6±11.3 years. The mean HD period was 3.5±3.2 years. Hypertension and diabetes mellitus (DM) was found in 81.1% and 34.6%, respectively. The major ocular abnormalities found were cataract (206 eyes; 64.78% (95% CI 59.53-70.03)), followed by CCC (135 eyes; 42.45% (95 % CI 37.02-47.88)). In a multivariate model, higher education (odds ratio (OR) 0.17; 95% CI 0.04-0.74), hypertension (OR 0.15; 95% CI 0.03-0.79), DM (OR 10.49; 95% CI 1.57-70.06), Systolic Blood Pressure (SBP) 120-129 mmHg (OR 0.05; 95% CI 0.003-0.69), SBP >140 mmHg (OR 0.05; 95% CI 0.004-0.67), Diastolic Blood Pressure (DBP) 80-89 mmHg (OR 7.44; 95% CI 1.13-48.73), and DBP >90 mmHg (OR 48.47; 95% CI 3.4-692.03) showed significant association with cataract. Meanwhile, there was no significant association between CCC and any predictor. CONCLUSION: Cataract and CCC were found to be the major ocular abnormalities among HD patients in this study, with DM and higher DBP as the risk factors for cataract. This finding supports recommendations for integrated regular eye screening in HD patients.

The Impact of Travel Distance to Delayed Presentation and Follow-up Attendance of Retinal Detachment Cases in Surabaya, Indonesia.

Objectives: To assess the delayed presentation of Retinal Detachment (RD), its association from travel distance to the referral hospital (TDH), the period from symptom onset to consultation (SO-C), Proliferative vitreoretinopathy (PVR) severity, and 6 months follow-up attendance (6mo-FA). Method: A retrospective review based on medical records. Age, sex, initial best-corrected visual acuity (BCVA), TDH, SO-C, PVR type, and 6mo-FA were recorded. Multivariable ordered logistic regression was used to analyze the association between TDH and SO-C, and SO-C and PVR severity. Multivariable logistic regression was used to analyze 6mo-FA according to TDH. Multiple linear regression was used to assess the association between initial BCVA and TDH. Age and sex were included in all multivariable adjustments. Results: A total of 387 patients had RD with 59.2% predominantly males and the mean age±SD was 46.3±13.9 years. The initial BCVA of less than 3/60 was 81.1%. The averages of SO-C and TDH were 183.5±456 days and 160.9±364 km, respectively. The TDH of more than 120 km distance was significantly associated with longer SO-C (adjusted OR 1.78; CI 95% 1.09-2.92). PVR was noted in 17.6% of patients. The SO-C of 31-60 days was significantly associated with PVR severity (adjusted OR 4.28; CI 95% 1.47-12.51). The TDH of more than 120 km distance was significantly associated with 6mo-FA (adjusted OR 0.46; CI 95% 0.27-0.93). Conclusions: Long TDH was significantly associated with a longer period from symptom onset to consultation and 6mo-FA. Hence, accessible eye care is essential to refer RD cases in a timely fashion.