Efficacy of ophthalmic examinations for predicting vascular calcification in patients undergoing maintenance hemodialysis

Background In maintenance hemodialysis (MHD) patients, vascular calcification can be detected not only in coronary vessels but also in ocular areas. However, ophthalmic examinations are not sufficiently validated to measure the degree of vascular calcification. Methods This study was performed prospectively, involving 32 MHD patients. Calcium deposition in the cornea and conjunctiva was checked using a slit lamp and anterior photography. Conjunctival and corneal calcification (CCC) score was calculated and the severity of CCC was graded. Extent of invasion in the corneal limbus and center was identified. Coronary artery calcium (CAC) deposit was scored using computer tomography, and cardiac function was investigated by echocardiogram. We divided patients into two groups: mild and moderate/severe groups according to the CCC scores. Results Mean CAC scores were 354.6 and 1,494.2 in the mild and moderate/severe groups. Mean extent of invasion in the corneal limbus and center was significantly higher in the moderate/severe groups than in the mild group. Parathyroid hormone was significantly higher in the moderate/severe groups than in the mild group and ejection fraction was significantly lower in the moderate/severe groups than in the mild group. The CCC score was positively associated with the CAC score, the extent of invasion in the corneal limbus and center, and the parathyroid hormone level. The extent of invasion in the corneal limbus and center was positively associated with the CAC score. The CCC score was negatively associated with ejection fraction. Conclusion The CCC score and the extent of invasion in the corneal limbus and center can predict vascular calcification in MHD patients.