Ophthalmological follow-up of diabetic patients after kidney transplantation.
Visual acuity (VA) and changes in diabetic retinopathy after kidney transplantation were prospectively evaluated in 29 patients with type 1 diabetes. At the time of transplantation, 9 patients (31%) had background retinopathy (RP) and 20 patients (69%) had proliferative RP in one eye or both eyes. During the follow-up period of 0.5-4 years (median, 3.0 years), background RP remained stable in 13 of 22 eyes (59.1%), improved in 6 eyes (27.3%) and changed to proliferative RP in 3 eyes (13.6%). Of the 26 eyes with proliferative RP, proliferative changes decreased in 6 (23.1%) and increased in 4 (15.4%). Initially 11 eyes were blind (VA less than counting fingers at 1 m), and in 1 of them the VA improved after vitrectomy. In 42 of the remaining 47 eyes (89.4%) the VA remained unchanged (within 2 lines better or worse), in 4 eyes (8.5%) it improved and in 1 eye (2.1%) it deteriorated. Five patients died during the follow-up period. These results indicate that in most diabetic patients, retinopathy remains stable or improves after kidney transplantation, but regular ophthalmological follow-up is important for the discovery of eyes in which further treatment is indicated.
Laatikainen
L
L
Department of Ophthalmology, University of Helsinki, Finland.
Summanen
P
P
Ekstrand
A
A
Groop
L
L
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012160:Retina / Q000503:physiopathology; D014792:Visual Acuity