A 10-year monitoring of the eyesight in patients after kidney transplantation

Medicine (Baltimore). 2018 Feb;97(6):e9822. doi: 10.1097/MD.0000000000009822.

Abstract

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.

MeSH terms

  • Adult
  • Cataract* / diagnosis
  • Cataract* / epidemiology
  • Cyclosporine / therapeutic use
  • Diabetic Retinopathy* / diagnosis
  • Diabetic Retinopathy* / epidemiology
  • Female
  • Humans
  • Hypertensive Retinopathy* / diagnosis
  • Hypertensive Retinopathy* / epidemiology
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation* / adverse effects
  • Kidney Transplantation* / methods
  • Male
  • Middle Aged
  • Pilot Projects
  • Poland / epidemiology
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / epidemiology
  • Postoperative Period
  • Risk Factors
  • Tomography, Optical Coherence / methods
  • Tonometry, Ocular / methods
  • Visual Acuity

Substances

  • Immunosuppressive Agents
  • Cyclosporine