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[儿童及青少年血液透析及肾移植后的眼部表现]

[Ocular findings in hemodialysis and following kidney transplantation in childhood and adolescence].

作者信息

Prskavec F H, Balzar E, Klemen C, Juchem M, Khoss A, Hienert I

机构信息

1. Universitäts-Augenklinik Wien.

出版信息

Klin Monbl Augenheilkd. 1987 Nov;191(5):382-4. doi: 10.1055/s-2008-1050536.

Abstract

Between August 1980 and January 1987, 23 patients undergoing treatment for chronic renal failure underwent eye examinations. Hemodialysis and subsequent kidney transplants were performed in 18 patients; in two patients a kidney transplant was performed alone, and in three others hemodialysis without transplant. The interval between dialysis and transplantation averaged 23.1 months, the mean follow-up after transplantation 20 months. Patients who underwent hemodialysis alone were followed up for periods of two, three and 85 months. The patients' ages when hemodialysis treatment was first instituted ranged from six to 17 years (average 11.8 years). The mean age at the time kidney transplants were performed was 13.6 years (ranging from one to 17 years). Seventeen patients had conjunctival and corneal infiltrations in the area of the palpebral fissure. In two cases infiltrations were confined to the conjunctiva. Four patients had no pathologic changes, in either the cornea or the conjunctiva. Slitlamp examination revealed subcapsular losses of lens transparency in eight patients; these losses were manifested by delicate punctiform and patchy configurations. In nine cases fundus ophthalmoscopy revealed constricted retinal arteries. Within the period of observation all but one of the patients had unchanged vision. The one exception (cystinosis) had reduced visual acuity due to an accumulation of crystalline inclusions in the cornea.

摘要

1980年8月至1987年1月期间,23名接受慢性肾衰竭治疗的患者接受了眼部检查。18名患者进行了血液透析及随后的肾脏移植;2名患者仅接受了肾脏移植,另外3名患者仅进行了血液透析而未进行移植。透析与移植之间的间隔平均为23.1个月,移植后的平均随访时间为20个月。仅接受血液透析的患者随访时间分别为2个月、3个月和85个月。首次开始血液透析治疗时患者的年龄在6至17岁之间(平均11.8岁)。进行肾脏移植时的平均年龄为13.6岁(范围为1至17岁)。17名患者在睑裂区域出现结膜和角膜浸润。2例浸润仅局限于结膜。4例患者的角膜或结膜均无病理改变。裂隙灯检查发现8例患者晶状体囊下透明度丧失;这些丧失表现为细微的点状和片状形态。9例患者眼底检查发现视网膜动脉变窄。在观察期内,除1例患者(胱氨酸病)外,所有患者视力均未改变。该例外患者因角膜中晶体包涵体的积聚而视力下降。

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