Raczyńska Dorota, Ślizień Mateusz, Bzoma Beata, Dębska-Ślizień Alicja, Glasner Leopold, Raczyńska Krystyna
Department of Ophthalmology, Medical University of Gdansk Department of Nephrology, Transplantology and Internal Diseases Medical University of Gdansk, Poland.
Medicine (Baltimore). 2018 Feb;97(6):e9822. doi: 10.1097/MD.0000000000009822.
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.
一项针对肾移植患者视力特征进行10年分析的试点研究,目的是随后对同一人群进行更广泛的研究。该研究纳入了2007年和2008年接受肾移植的25例患者的50只眼睛。所有患者均接受了:视力测量、眼压测量、裂隙灯检查和光谱光学相干断层扫描。在10年观察期内观察到的眼部变化主要包括:白内障(48%)、高血压性血管病变(28%)、糖尿病性黄斑水肿(16%)和青光眼(16%)。肾移植10年后,15例患者(60%)视力下降。在视力下降的患者中,67%的病因是白内障,而视力无变化的患者(n = 10)中只有1例被诊断为白内障。白内障患者更常接受环孢素治疗,且差异具有统计学意义(73%对21%;P <.05)。将高血压性血管病变患者与对照组进行比较显示,第一组的肌酐水平在统计学上显著更高(1.6对1.16 mg/dL;P <.05)。血管病变患者在移植前接受肾脏替代治疗的时间也更长(57对26个月,P >.05),并且该组再次移植后的患者在统计学上也更多(43%对5%,P <.05)。肾移植患者最常见的眼科诊断包括白内障、糖尿病视网膜病变和高血压性血管病变。60%的患者出现视力下降,主要是白内障进展的结果。环孢素对白内障进展的影响显著。高血压性血管病变的诊断与移植肾的功能较差相对应。