A 10-year monitoring of the eyesight in patients after kidney transplantation

Abstract

A pilot study of a 10-year analysis of the eyesight characteristics in patients after renal transplantation with a view to a later wider study of the same population.The study encompassed 50 eyes in 25 patients who underwent renal transplantation in the years 2007 and 2008. All patients underwent: visual acuity measurement, tonometry, slit lamp examination, and spectroscopic optical coherence tomography.Changes in the eyes observed during the 10-year observation period included mostly: cataract (48%), hypertensive angiopathy (28%), diabetic macular edema (16%), and glaucoma (16%). Ten years after the renal transplant visual acuity declined in 15 patients (60%). In 67% of those with eyesight deterioration the cause was cataract, while in patients with no changes in the eyesight (n = 10) cataract was diagnosed only in one. Patients with cataracts had been more often treated with cyclosporine, and that difference was statistically significant (73% vs 21%; P < .05). Comparing patients with hypertensive angiopathy with controls has shown that in the first group creatinine levels were statistically significantly higher (1.6 vs 1.16 mg/dL; P < .05). Patients with angiopathy had been also longer on renal replacement therapy before transplant (57 vs 26 months, P > .05), and this group included also statistically more persons after retransplantation (43% vs 5%, P < .05).Most frequent ophthalmological diagnoses in patients after a kidney transplant include cataract, diabetic retinopathy, and hypertensive angiopathy. Visual acuity deterioration was seen in 60% of patients and was mainly the effect of cataract progress. The effect of cyclosporine on cataract progress was significant. The diagnosis of hypertensive angiopathy corresponded with poorer function of the transplanted kidney.

Common pathogenic aspects of diabetic retinopathy and nephropathy. Kidney transplantation and the course of diabetic retinopathy

“…Наиболее частой причиной снижения остроты зрения у реципиентов в послеоперационном периоде была катаракта [46,[48][49][50]. В работе D.H. Berman et al частота экстракций катаракты среди пациентов после трансплантации составила 33% случаев, что было значительно больше, чем в группе диализных пациентов (9%) [46].…”

“…R. Roy et al сообщили о 44% случаев экстракции катаракты после трансплантации почки [49]. По результатам 10-летнего наблюдения за реципиентами D. Raczyńska et al обнаружили катаракту у 45% пациентов с ДР [50]. Авторы установили значительную корреляцию развития катаракты с системным применением кортикостероидов [48,50] и иммуносупрессоров [50].…”

“…По результатам 10-летнего наблюдения за реципиентами D. Raczyńska et al обнаружили катаракту у 45% пациентов с ДР [50]. Авторы установили значительную корреляцию развития катаракты с системным применением кортикостероидов [48,50] и иммуносупрессоров [50]. заключение ДР и ДН остаются частыми микрососудистыми осложнениями СД и оказывают значительное влияние на здоровье пациентов.…”

Review of anaesthetic management for cataract surgery in transplant recipients

“…Transplant recipients are susceptible to cataract formation, and bilateral posterior subcapsular cataracts (86% bilateral versus 14% unilateral) 12 are most commonly encountered after renal transplantation. 13 The reported incidence varies from 23% to 58%, with a lower incidence in the early years, and plateaus at 15 years post kidney transplantation. Contributing factors include the use of cyclosporine 13 and high cumulative corticosteroid dose (prednisolone dose >3 mg/kg/month).…”

“…13 The reported incidence varies from 23% to 58%, with a lower incidence in the early years, and plateaus at 15 years post kidney transplantation. Contributing factors include the use of cyclosporine 13 and high cumulative corticosteroid dose (prednisolone dose >3 mg/kg/month). 14 Acute rejection episodes treated with pulsed steroids may result in a higher risk of developing cataracts.…”