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Fang-Yi Tsai, Ling-Ing Lau, An-Fei Li, Shih-Jen Chen, Catherine Jui-Ling Liu; Factors Associated with Acute Worsening of Retinopathy in Diabetic Patients after Pancreas Transplantation in Chinese. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1896. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Acute worsening (AW) of diabetic retinopathy (DR) is noted in some patients after pancreas transplantation (PT). The aim of this retrospective observational clinical study is to identify the risk factors of AW of diabetic retinopathy after PT in Chinese population.
A retrospective study reviewed all diabetic patients who received PT in a tertiary medical center, Taipei Veterans General Hospital, from September 2003 to April 2013. Systemic and ophthalmic factors were recorded and compared between patients with and without AW of DR. Acute worsening of retinopathy is defined as the development of bilateral macular edema and peripapillary soft exudate with significant visual blurring within 3 months after PT.
There were 70 eligible patients enrolled in this study. Eight patients (11.4 %) developed AW, all of them had type 1 diabetes and received pancreas transplantation alone. Patients with AW of DR showed significantly younger age (26.4 ± 6.8 years vs 34.3 ± 9.0 years, p = 0.009), shorter duration of diabetes (11.0 ± 4.3 years vs 17.0± 7.4 years, p = 0.024), better renal function with higher baseline creatinine clearance rate (119.40 ± 39.83 ml/min vs 54.00 ± 47.97, p = 0.002), and higher percentage of smoking (62.5 % vs 9.7 %, p = 0.002). They had higher baseline HbA1c (12.74 ± 2.23 % vs 8.42 ± 1.68 %, p < 0.001), larger HbA1c reduction within 3 months (6.65 ± 2.43 % vs 2.86 ± 1.65 %, p < 0.001), and lower systolic blood pressure within 3 months (142.5 ± 10.7 mmHg vs 165.0 ± 26.0 mmHg, p =0.011). They all had no or mild DR at baseline (p = 0.003) and none of them received PRP before transplantation (p = 0.006). Multivariate logistic regression showed that smoking (p = 0.049) and pre-operative HbA1c (p = 0.031) were the significant risk factor for AW of DR after PT.
Our study showed that young smoking diabetes patients with high baseline HbA1c and mild DR change before PT had higher risk of AW of DR after PT in Chinese population.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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