The effects of renal transplantation on diabetic retinopathy: Clinical course and visual outcomes.
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Date
2013-10
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Abstract
Purpose: To elucidate the clinical course of diabetic retinopathy (DR) after renal transplantation (RT)
in a hospital based cohort. Design: Retrospective study. Materials and Methods: A total of 56 eyes of
28 patients, who had DR and end stage renal disease (ESRD) due to diabetes and had undergone RT, were
included in this study. Diagnosis and management of DR was carried out according to early treatment of
diabetic retinopathy study (ETDRS) guidelines. DR outcome was defined as worsening if there was >2 step
increase in the grade of DR or need for intervention such as laser (macular or pan retinal) or vitreoretinal
surgery, improvement for <2 step change while stabilization was defined if DR remained within these
two limits. Results: The mean age of the patients were 48.9 years. The mean duration of diabetes in the
study group was 12.7 years. The patients were followed‑up for a mean period of 52.2 ± 43.6 months. The
pre‑transplant mean Best corrected visual acuity (BCVA) was 0.4876 log MAR units and post‑transplant
mean BCVA was 0.4858 (P = 0.05). However, there was a significant visual improvement in first 20 months
of renal transplant (P = 0.03). Worsening of DR was noted in 16 (32%) eyes whereas improvement was seen
in 4 (8%). However, majority of eyes 30 (60%) had stable retinopathy at the final follow‑up. Conclusions:
RT stabilized the retinopathy status in the majority of patients although in a minor subset the disease course
was unpredictable.
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Keywords
Diabetic retinopathy, renal transplant, visual outcome
Citation
Roy Rupak, Das Manmath K, Pal Bikramjit P, Ganesan Suguneswari, Raman Rajiv, Sharma Tarun. The effects of renal transplantation on diabetic retinopathy: Clinical course and visual outcomes. Indian Journal of Ophthalmology. 2013 Oct ; 61(10): 552-556.