Jayamanne D G, Porter R
Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Nephrol Dial Transplant. 1998 Aug;13(8):2070-3. doi: 10.1093/ndt/13.8.2070.
Long-term visual outcome following renal transplantation is poorly documented in medical literature. The purpose of this study was to determine the ocular morbidity in a group of renal transplant patients receiving immunosuppressive therapy.
Patients who had undergone renal transplantation were identified from the renal outpatient register, and patients who were at least 8 years posttransplantation were included in the study. Ocular examination was on average 14.6 years post-surgery. There were 43 males and 28 females, with ages ranging from 29 to 74 years. The patients had undergone renal transplantation between March 1968 and September 1986. The ophthalmic examinations were carried out over a 15-month period in a research clinic.
Visual acuity was greater than or equal to 6/9 in 75% of the eyes. 10% of eyes had visual acuities of less than 6/24. Four eyes had central/branch retinal-vein occlusions; four eyes had posterior subcapsular lens opacities; three eyes had optic atrophy; one eye had complications of proliferative diabetic retinopathy; one eye had diabetic maculopathy and one eye had a central retinal artery occlusion. Only five eyes had irreversible visual loss resulting in visual acuities of less than 6/60.
The incidence of sight-threatening complications in long-term survivors of renal transplantation was low. The results indicate that long-term prognosis for normal vision in patients who have undergone renal transplantation is good. Regular ophthalmic examinations are recommended for early detection of sight-threatening complications.
肾移植后的长期视力结果在医学文献中的记载较少。本研究的目的是确定一组接受免疫抑制治疗的肾移植患者的眼部发病率。
从肾脏门诊登记中识别出接受过肾移植的患者,纳入研究的患者为移植后至少8年。眼部检查平均在术后14.6年进行。有43名男性和28名女性,年龄在29至74岁之间。这些患者在1968年3月至1986年9月期间接受了肾移植。眼科检查在一家研究诊所进行了15个月。
75%的眼睛视力大于或等于6/9。10%的眼睛视力低于6/24。4只眼睛发生中央/分支视网膜静脉阻塞;4只眼睛有后囊下晶状体混浊;3只眼睛有视神经萎缩;1只眼睛有增殖性糖尿病视网膜病变并发症;1只眼睛有糖尿病性黄斑病变,1只眼睛有视网膜中央动脉阻塞。只有5只眼睛出现不可逆视力丧失,导致视力低于6/60。
肾移植长期存活者中威胁视力并发症的发生率较低。结果表明,肾移植患者正常视力的长期预后良好。建议定期进行眼科检查以早期发现威胁视力的并发症。