Berindán K, Nemes B, Szabó R P, Módis L
Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Hungary.
Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Hungary.
Transplant Proc. 2017 Sep;49(7):1526-1529. doi: 10.1016/j.transproceed.2017.06.016.
The aim of the study was to perform complete ophthalmic examinations in patients after renal transplantation to determine ocular alterations and condition of the eyes. Moreover, ophthalmic findings were correlated with certain clinical characteristics related to transplantation such as post-operative renal functions and immunosuppressive regimen. The study was performed on 84 eyes of 42 patients who had received a renal transplant at least 6 months earlier. All patients underwent a complete ophthalmologic examination. In addition, in 33 (78.6%) patients peripapillary retinal nerve fiber layer (RNFL) thickness was determined using optical coherence tomography (Stratus OCT, Zeiss, Germany), which is a unique finding among renal transplantation patients. Recipients received immunosuppressive therapy consisting of tacrolimus, mycophenolate mofetil, and corticosteroid. Of 42 patients, 19 (45%) were women and 23 (55%) were men. The age of the patients ranged from 26 to 74 years, the mean age was 53.4 years. At least one ocular abnormality could be detected in 37 patients (88%), including impaired visual acuity (n = 31, 74%), keratoconjunctivitis sicca (n = 6, 14.3%), pinguecula (n = 3, 7.1%), arcus lipoides (n = 1, 2.4%), cataracts (n = 24, 57.1%), glaucoma (n = 2, 5%), retinal drusen (n = 6, 14.3%), and hypertensive or atherosclerotic retinopathy (n = 22, 52.4%). Twenty-five patients (75.8%) have reduced RNFL thickness. Cataract formation was positively correlated with age and usage of methylprednisolone. Moreover, RNFL thickness loss was correlated with transplantation duration and postoperative infections. Our study suggests that ocular disorders are frequent among renal transplantation patients. Besides immunosuppression and postoperative infection, aging is a high-risk factor in such cases.
本研究的目的是对肾移植术后患者进行全面的眼科检查，以确定眼部改变和眼睛状况。此外，眼科检查结果与移植相关的某些临床特征相关，如术后肾功能和免疫抑制方案。该研究对42例至少在6个月前接受肾移植的患者的84只眼睛进行。所有患者均接受了全面的眼科检查。此外，33例（78.6%）患者使用光学相干断层扫描（Stratus OCT，德国蔡司公司）测定了视乳头周围视网膜神经纤维层（RNFL）厚度，这在肾移植患者中是一项独特的发现。受者接受了由他克莫司、霉酚酸酯和皮质类固醇组成的免疫抑制治疗。42例患者中，19例（45%）为女性，23例（55%）为男性。患者年龄在26至74岁之间，平均年龄为53.4岁。37例患者（88%）至少可检测到一种眼部异常，包括视力受损（n = 31，74%）、干眼症（n = 6，14.3%）、睑裂斑（n = 3，7.1%）、脂性角膜弓（n = 1，2.4%）、白内障（n = 24，57.1%）、青光眼（n = 2，5%）、视网膜玻璃膜疣（n = 6，14.3%）以及高血压或动脉粥样硬化性视网膜病变（n = 22，52.4%）。25例患者（75.8%）RNFL厚度降低。白内障形成与年龄和甲基泼尼松龙的使用呈正相关。此外，RNFL厚度损失与移植持续时间和术后感染相关。我们的研究表明，肾移植患者中眼部疾病很常见。除了免疫抑制和术后感染外，衰老在这些病例中也是一个高危因素。
