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Ocular Findings among the Patients of Renal Transplantation
Madhu Thapa1, Gulshan Bahadur Shrestha, Pragati Gautam
1BP Koirala Lions Centre for Ophthalmic Studies, Department of Ophthalmology, Maharajgunj Medical Campus, IOM.
Introduction:
Renal diseases are on rise globally due to increased incidence of non-communicable diseases as well as primary-kidney diseases and frequent use of nephrotoxic drugs. Only definite treatment of End-Stage-RenalDisease (ESRD) is renal transplantation. Immuno-suppressive-drugs are prescribed lifelong after renal transplantation especially steroids which can lead to various sight-threatening complications.
Methods:
This cross sectional, observational study included 62 eyes of 31 patients who had undergone renal transplantation, at least 3 months prior were referred from Nephrology Department. Comprehensive eye evaluation was done at B. P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS), Department of Ophthalmology, Institute of Medicine.
Results:
The average age of participants was 37 ±10.57 years with 77.4 % (n=24) male. Mean duration of renal transplant was 5.10 ± 3.61 years. Fifty-eight percent (n=18) had hypertensive kidney disease. Diabetes Kidney disease, recurrent UTI, CKD of unknown causes and combined case of diabetes plus hypertension were seen in 6.4% (n=2) each. Sixty percent of the patients had some kind of ocular involvement. Twenty-nine percent (n=18) had subnormal visual acuity of ≤ 6/9. Cataract was seen in 29% (n=18) of eyes followed by pinguecula (17.7%, n=11) and hypertensive-retinopathy (17.7%, n=11). Glaucoma and Diabetic-retinopathy were seen only in 6.4% (n= 4) of each eyes. There was no association seen between ocular findings with cause of renal transplant, duration of transplant and renal function status in bivariate analysis.
Conclusions:
Some form of ocular abnormality is commonly seen in patients of renal transplantation who are on immunosuppressive drugs. However, incidence of sight threatening complications are rare.
Insights
Ocular abnormalities are common in kidney transplant recipients on immunosuppressive drugs, but sight-threatening complications are rare. This study highlights the need for regular eye evaluations in these patients to monitor for potential vision issues.
Area of Science:
- Ophthalmology
- Nephrology
- Immunology
Background:
- Global rise in renal diseases necessitates renal transplantation.
- Lifelong immunosuppressive drugs, particularly steroids, are required post-transplant.
- These medications can lead to sight-threatening ocular complications.
Purpose of the Study:
- To investigate the prevalence of ocular abnormalities in patients who have undergone renal transplantation.
- To assess the incidence of sight-threatening complications in this patient group.
Main Methods:
- Cross-sectional, observational study of 31 renal transplant patients (62 eyes).
- Patients were referred from the Nephrology Department at least 3 months post-transplant.
- Comprehensive eye evaluations were conducted.
Main Results:
- 60% of patients exhibited some ocular involvement.
- Cataracts (29%), pinguecula (17.7%), and hypertensive retinopathy (17.7%) were most common.
- Sight-threatening conditions like glaucoma and diabetic retinopathy were less frequent (6.4% each).
Conclusions:
- Ocular abnormalities are frequently observed in renal transplant recipients on immunosuppressants.
- The incidence of severe, sight-threatening complications appears to be low.
