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Diabetic retinopathy outcomes in patients undergoing pancreatic transplants in West London
Author(s) -
Szymanska Maja,
Yap Timothy,
Normando Eduardo,
Cordeiro Francesca
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2019.5289
Subject(s) - medicine , diabetic retinopathy , diabetes mellitus , retinopathy , visual acuity , incidence (geometry) , type 2 diabetes mellitus , grading (engineering) , surgery , retrospective cohort study , physics , civil engineering , engineering , optics , endocrinology
Purpose To quantify the proportion of diabetic patients undergoing pancreas transplant in West London and their service use. To characterise their long‐ and short‐term retinopathy grading and visual function outcomes following surgery, the incidence of ophthalmic interventions and factors associated with DR progression. Methods Retrospective study of diabetic patients undergoing pancreatic transplant in West London between 2001–2018. Key outcomes examined included visual acuity (VA) and retinopathy grading, as well as service use and subsequent ophthalmic treatments. Patients with failed pancreatic transplants acted as a comparison group. Results Data from 56 patients were analysed including 51 patients with Type 1 and 5 with Type 2 diabetes mellitus. Mean age (±SD) at the time of transplant was 42 ±9 years with mean duration of disease 24 ±7 years. Data from 56 patients were analysed including 51 patients with Type 1 and 5 with Type 2 diabetes mellitus. Among them, 63% of patients were found under diabetic eye screening programme and 11% under ophthalmic secondary care at the time of transplant. At the time of transplant, 7% of eyes had no DR, 13% had background retinopathy, 13% had non‐proliferative and 67% had stable or treated proliferative retinopathy. During short‐term follow‐up (3 years), 17% of eyes developed DR progression. Amongst patients who underwent a successful transplant, there was no significant change in mean VA before and after the intervention. Long‐term follow‐up (6.6 years) revealed no significant difference in mean VA between patients with successful and failed transplants. Conclusion This study shows that pancreatic transplantation does not guarantee prevention of DR progression. Close monitoring of these patients both in primary and secondary care is advised, however, favourable long‐term visual outcomes are possible with appropriate and timely treatment.