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使用慢性低剂量类固醇的肾移植患者的视网膜异常谱

Spectrum of retinal abnormalities in renal transplant patients using chronic low-dose steroids.

作者信息

van Dijk Elon H C, Soonawala Darius, Rooth Vera, Hoyng Carel B, Meijer Onno C, de Vries Aiko P J, Boon Camiel J F

机构信息

Department of Ophthalmology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.

Department of Medicine, Division of Nephrology, and Leiden Transplant Center, Leiden University Medical Center, Leiden, the Netherlands.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2017 Dec;255(12):2443-2449. doi: 10.1007/s00417-017-3823-6. Epub 2017 Oct 23.

Abstract

PURPOSE

To assess the ophthalmological characteristics of asymptomatic patients with a renal transplant on chronic low-dose steroids for at least the last 2 years prior to examination.

METHODS

Cross-sectional study. All patients underwent an extensive ophthalmological examination.

RESULTS

Of the 37 included patients [25 male, 12 female; 59 ± 11 years (range, 38-77 years)] ophthalmological phenotyping revealed abnormalities in 22 patients (59%). Findings characteristic for (subclinical) central serous chorioretinopathy were detected in ten patients (27%), including two patients with serous subretinal fluid in the macula. An epiretinal membrane of the macula was present in six patients (16%). Mean subfoveal choroidal thickness was significantly increased in patients with ophthalmological abnormalities, in comparison with patients without abnormalities.

CONCLUSIONS

Retinal abnormalities are common in the majority of renal transplant patients using chronic low-dose steroids. These retinal changes may be associated with the renal disease and/or the effect of chronic steroid use on the choroid and retina.

摘要

目的

评估在检查前至少过去2年一直使用慢性低剂量类固醇的肾移植无症状患者的眼科特征。

方法

横断面研究。所有患者均接受了全面的眼科检查。

结果

在纳入的37例患者中(25例男性,12例女性;年龄59±11岁,范围38 - 77岁),眼科表型分析显示22例患者(59%)存在异常。在10例患者(27%)中检测到(亚临床)中心性浆液性脉络膜视网膜病变的特征性表现,其中包括2例黄斑区浆液性视网膜下液患者。6例患者(16%)存在黄斑区视网膜前膜。与无异常的患者相比,有眼科异常的患者黄斑中心凹下脉络膜厚度显著增加。

结论

在大多数长期使用低剂量类固醇的肾移植患者中,视网膜异常很常见。这些视网膜变化可能与肾脏疾病和/或长期使用类固醇对脉络膜和视网膜的影响有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bfd/5696484/b54045b88391/417_2017_3823_Fig1_HTML.jpg

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