97th DOG Annual Meeting 1999
PROGRESSION OF DIABETIC RETINOPATHY AFTER PANCREAS-KIDNEY TRANSPLANTATION
P. Wölfelschneider, L. Blomberg, U. Gronemeyer
The increasing retinopathy in patients with diabetes mellitus -type I is a serious complication often combined with loss in visual acuity. We analyzed the development of retinal changes in patients after succesful combined pancreas-kidney transplantation.
Patients and Methods: We examined 28 patients, 15 men and 13 women with diabetes mellitus type I. The average age of the patients was 36 years (26-49). The patients suffered for an average time of 25 years (15 - 46) diabetes mellitus. Follow-up time was 10 month in average (6 mon - 2 years). The examination included a complete ophthalmologic status and a photographic documentation. In addition to these examinations we assesed an ETDRS-Score in the course.
Results: During the mean follow-up 23 of 28 patients (82%) stabilization was found, although the patients had very different stages of diabetic retinopathy at the time of transplantation. In 5 patients the score worsened, but only 2 of the patients (7%) status deteriorated. One patient underwent focal laser treatment after developing a macular edema, the second patient had a vitreous hemorrhage. 4 patients (14%) developed a cataract.
Conclusion: Nearly all patients had a stabilization of their fundus pathology, in particular patients with proliferative changes before transplantation. The development of lens opacification and other side effects of the immunosuppressive treatment after transplantation should be investigated in further studies.
Department of Ophthalmology, University of Bochum, Bochum, Germany