[Changes in diabetic retinopathy and visual acuity in patients with end-stage diabetic nephropathy after the introduction of hemodialysis].
OBJECTIVE
To study the diabetic retinopathy (DR) and visual acuity in patients with end-stage diabetic nephropathy in the predialysis period and the changes after the initiation of hemodialysis at Tokyo Postal Service Agency Hospital (TPSAH).


METHODS
We retrospectively analyzed the systemic conditions and the stage of DR and visual acuity in the medical records, of 24 patients 48 eyes (male: female=20 : 4) with diabetic nephropathy, who were started on hemodialysis between June 1994 and August 2003 at TPSAH, and were followed ophthalmologically more than 6 months after the start of hemodialysis.


RESULTS
At the start of hemodialysis, 46 of 48 eyes (95.8%) had already been treated by retinal photocoagulation. The DR activity was assessed as "low" in 62.5% of the patients at the start of hemodialysis, but 6 months later, over 95% of the patients were assessed as having "low-activity". At the start of hemodialysis visual acuity was less than 0.1 in 21% of the eyes, and over 0.7 in 42% of the eyes, and the ratio was stable in the follow-up period. In 2 eyes the stage of diabetic retinopathy became worse by more than one grade in Fukuda's grading of diabetic retinopathy, and in 4 eyes more than a 2 grade alteration in visual acuity was observed.


CONCLUSIONS
After the start of hemodialysis, DR became less active relatively early, and only a few eyes became worse in visual acuity and DR.
Yoshimoto
Miwako
M
Department of Ophthalmology, Tokyo Postal Service Agency, Hospital, Fujimi, Chiyoda-ku, Tokyo 102-8798, Japan.
Matsumoto
Shun
S
D000328:Adult; D000368:Aged; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000628:therapy*; D003930:Diabetic Retinopathy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014792:Visual Acuity / Q000502:physiology*