Ophthalmic evaluation in patients after simultaneous pancreas-kidney transplantation (SPK) due to complications of type 1 diabetes mellitus, and in type 1 diabetic patients assessed for eligibility for SPK

Abstract

In the patients after SPK, we found a statistically significant correlation between atrophy in the photoreceptor inner segment/outer segment junction (IS/OS line) on OCT and the pre-transplant HbA1 level. In the group of patients evaluated before and within one year after SPK, we confirmed activation of retinopathy in 66.7% of examined eyes. OCT performed during the assessment of eligibility for SPK revealed atrophy in the IS/OS line in 47% of examined eyes. Conclusions: Changes in the retina associated with poor pre-transplant diabetes control determine the best achievable visual acuity even after long-term normalization of glycemia following SPK. Patients after SPK require frequent comprehensive ophthalmological follow-up examinations during the first year after transplantation because of the risk of diabetic retinopathy progression. Despite the limitations resulting from their base-line status, more than half of all patients after SPK (51%) have a visual acuity of > 0.6 at least in one eye, which is sufficient for independent functioning. Patients eligible for SPK exhibit macular changes on OCT, hypoperfusion on angio-OCT, and 47% atrophy in the IS/OS line.