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AIM: To observe the changes of intraocular pressure(IOP), ocular perfusion pressure(OPP), central anterior chamber depth(CACD)and subfoveal choroidal thickness(SFCT)in peri-hemodialysis in patients with end-stage diabetic nephropathy(ESDN), for evaluating the influences of hemodialysis(HD)on ocular blood supply of the ESDN patients. <p>METHODS: Totally 42 cases(84 eyes)of ESDN patients treated with HD in the Department of Nephrology were observed. Systolic and diastolic blood pressure, IOP with the hand-held rebound tonometer were measured at 30min before HD, 2h after HD duration and 30min after HD completion. OPP was calculated(OPP= 4/9 diastolic pressure + 2/9 systolic pressure - IOP). CACD measured by optical coherence measuring instrument(IOL-Master)and SFCT measured by optical coherence tomography(OCT)were observed at 30min before HD and 30min after HD completion. The outcomes were assessed by analysis of homogeneity test of variance, one-way ANOVA, LSD-<i>t</i> test and <i>t</i>-test, to look for differences of the parameters in various time of HD. <p>RESULTS: Totally 84 eyes of ESDN patients: in 30min before HD, 2h after HD duration and 30min after HD completion, systolic blood pressure was no statistically significant(<i>F</i>=0.254, <i>P</i>=0.783), and diastolic blood pressure was no statistically significant(<i>F</i>=0.114, <i>P</i>=0.896), and IOP was statistically significant(<i>F</i>=7.527, <i>P</i>=0.001), and OPP was statistically significant(<i>F</i>=4.692, <i>P</i>=0.027). In 2h after HD duration and 30min after HD completion, IOP was statistically significant(<i>t</i>=-3.646, <i>P</i>=0.001), and OPP was statistically significant(<i>t</i>=2.321, <i>P</i>=0.022). In 30min before HD and 30min after HD completion, increase of IOP was statistically significant(<i>t</i>=-2.977, <i>P</i>=0.003), and OPP was no statistically significant(<i>t</i>=0.219, <i>P</i>=0.872), and decrease of CACD was statistically significant(<i>t</i>=6.291, <i>P</i><0.05), and decrease of SFCT was statistically significant(<i>t</i>=5.736, <i>P</i><0.05). <p>CONCLUSION: IOP increasing, OPP transiently decreasing, CACD shallow and SFCT thin were presented in peri-hemodialysis. It is important to evaluate eye conditions of ESDN patients before HD, and to take effective preventive measures to reduce the possible risk factors in peri-hemodialysis.