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State of the Retina and Visual Functions before and after Pancreatic Transplantation (Clinical Case)

https://doi.org/10.18008/1816-5095-2022-4-917-922

Abstract

In this report, we reflected a clinical case of the course of the proliferative stage of diabetic retinopathy in a patient suffering from type 1 diabetes mellitus (DM) and end-stage diabetic nephropathy (DN) before and after simultaneous pancreas and kidney transplantation. As a result of successful surgical treatment of DM and DN was achieved physiological normoglycemia (change in fasting blood glucose from 11 to 5.1 mmol/l, glycated hemoglobin level from 9.2 to 5.7 %) and relief of uremic syndrome (change in serum creatinine from 632 to 77,5 µmol/l, urea from 13 to 6 mmol/l, glomerular filtration rate from 7.1 to 83.5 ml/min/1.73 m2). By the end of the first year of the post-transplantation period according to ophthalmoscopy data on the fundus no regression of the initial and addition of new diabetic changes was recorded and according to special instrumental methods of research was recorded a partial improvement hemoperfusion in superficial (an increase in the whole perfusion density: OD — from 24 to 35 %; OS — from 23 to 33 %) and deep (increase in the whole perfusion density: OD — from 5 to 13 %; OS — from 4 to 6 %) capillary plexus, a decrease in the central thickness of the retina (OD — from 269 to 257 µm; OS — from 271 to 253 µm) with resorption of intraretinal fluid in the right eye, improvement of the visual acuity (OD — from 0.5 to 0.7; OS — 0.6 to 0.7) and light sensitivity (macula light sensitivity threshold: OD — from 16.5 to 21.8 dB; OS — from 22.1 to 25.4 dB) of both eyes.

About the Authors

E. V. Bulava
Russian Medical Academy of Continuous Professional Education
Russian Federation

postgraduate student of the Ophthalmology department

Barrikadnaya str., 2/1, Moscow, 125993, Russian Federation 



I. V. Vorobyeva
Russian Medical Academy of Continuous Professional Education; RUDN University
Russian Federation

МD, Associate Professor of the Ophthalmology department

Barrikadnaya str., 2/1, Moscow, 125993, Russian Federation

Miklukho‑Maklaya str., 6, Moscow, 117198, Russian Federation 



A. V. Pinchuk
N.V. Sklifosovskiy Research Institute for Emergency Medical Aid; A.I. Evdokimov Moscow University of Medicine & Dentistry; Research Institute of Public Health Organization and Medical Management
Russian Federation

МD, Associate Professor of the Transplantology and artificial organs department, head of the Scientific department of kidney and pancreas transplantation

Bolshaya Sukharevskaya sq., 3, Moscow, 129090, Russian Federation

Delegatskaya str., 20/1, Moscow, 127473, Russian Federation

Bolshaya Tatarskaya str., 30, Moscow, 115184, Russian Federation 



References

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Review

For citations:


Bulava E.V., Vorobyeva I.V., Pinchuk A.V. State of the Retina and Visual Functions before and after Pancreatic Transplantation (Clinical Case). Ophthalmology in Russia. 2022;19(4):917-922. (In Russ.) https://doi.org/10.18008/1816-5095-2022-4-917-922

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ISSN 1816-5095 (Print)
ISSN 2500-0845 (Online)