Ophthalmological follow-up of diabetic patients after kidney transplantation

Visual acuity (VA) and changes in diabetic retinopathy after kidney transplantation were prospectively evaluated in 29 patients with type 1 diabetes. At the time of transplantation, 9 patients (31%) had background retinopathy (RP) and 20 patients (69%) had proliferative RP in one eye or both eyes. During the follow-up period of 0.5-4 years (median, 3.0 years), background RP remained stable in 13 of 22 eyes (59.1%), improved in 6 eyes (27.3%) and changed to proliferative RP in 3 eyes (13.6%). Of the 26 eyes with proliferative RP, proliferative changes decreased in 6 (23.1%) and increased in 4 (15.4%). Initially 11 eyes were blind (VA less than counting fingers at 1 m), and in 1 of them the VA improved after vitrectomy. In 42 of the remaining 47 eyes (89.4%) the VA remained unchanged (within 2 lines better or worse), in 4 eyes (8.5%) it improved and in 1 eye (2.1%) it deteriorated. Five patients died during the follow-up period. These results indicate that in most diabetic patients, retinopathy remains stable or improves after kidney transplantation, but regular ophthalmological follow-up is important for the discovery of eyes in which further treatment is indicated.