Ocular manifestations in renal allograft recipients

Abstract

Purpose: The aim of this study was to report the ocular findings in renal allograft recipients in India. Methods: A cross-sectional, comprehensive ophthalmic evaluation was performed, at least three months postrenal transplant, in 152 renal allograft recipients for the ocular findings. In addition, ocular findings were assessed for an association with the clinical variables like major etiologies of end-stage renal disease, pre-transplant dialysis duration, post-transplant duration, and dosage of immunosuppressive drugs. Results: 72.36% of the recipients (mean age, 38.16 ± 10.04 years) had at least one ocular finding at 3 ± 2.6 years (range, 0.3-14 years), postrenal transplant. Hypertensive retinopathy was the commonest ocular finding followed by posterior subcapsular cataract (20.4%), nuclear sclerosis (19.7%), diabetic retinopathy (15.1%), dry eye (11.2%), allergic conjunctivitis (9.9%), pterygium (6.6%), open-angle glaucoma (3.3%), meibomitis (3.3%), pinguicula (2.6%), chalazion (1.3%), subconjunctival haemorrhage (1.7%), central serous chorioretinopathy (1.7%), healed ocular toxoplasmosis (1.7%), papilledema (1.7%), and dry ARMD (1.7%). In addition, a significant association existed between some of the ocular findings with major aetiologies of ESRD, post-transplant duration, and dosage of immunosuppressive drugs. However, no association existed between the ocular findings and pre-transplant dialysis duration. Conclusion: Ocular findings are seen in 72.36% of the renal transplant recipients with hypertensive retinopathy being the commonest one. Hence, a mandatory regular ophthalmic screening of the recipients is recommended for an early detection and timely intervention to improve the quality of life.

Ocular Findings among the Patients of Renal Transplantation

“…However they did not find any diabetic retinopathy (Berindán et al, 2017). Many literatures have mentioned various vision threatening retinal findings like central serous chorioretinopathy, epiretinal membrane, Central retinal vein occlusion, Retinal pigment epithelial detachment which were not present in our study population (Ginu et al, 2021;van Dijk et al, 2017 ).…”

Cataract among Patients with Renal Transplantation in a Tertiary Care Centre: A Descriptive Cross-sectional Study

“… 8 On contrary, an Indian study has reported a much higher incidence (40%) of cataracts among patients with renal failure. 9 The mean use of steroids was 9.10±4.932 years ranging from 3 to 17 years, suggesting that the longer the duration of use of steroids more is the chances of cataract formation.…”

Eye Lesions in Patients After One Year of Kidney Transplantation

“…Ginu’s study accounted for only 11.2%, while the author’s study in the post-transplant population lasted from 0.3 to 14 years. 3 Sandhu’s study showed a post-transplant dry eye prevalence of 28% in subjects 3.3 ± 2.6 years after transplantation. 5 The difference in most dry eyes between our study and Ginu and Sandhu’s study may be due to factors, including patient populations, exam procedures, and methods used to assess dry eyes.…”

“…The explanation of the scaling difference from our study is due to the author’s classification criteria chosen by Keith Wagner Becker’s classification and the Early Treatment Diabetic Retinopathy Study (ETDRS). 3 Sandhu’s study found that the incidence of retinal lesions due to hypertension in patients after kidney transplantation was 40%, diabetic retinopathy was 12%, and other lesions accounted for 10%. Like the Ginu study, Sandhu uses Keith Wagner Becker’s retinal lesions classification system.…”

“…1 Eye lesions have been shown at different rates in studies when using systemic immunosuppressants. [2][3][4][5] These lesions predate kidney transplantation and then continue to progress. Or it could be new lesions after transplantation.…”