Miwako Yoshimoto1, Shun Matsumoto. 1. Department of Ophthalmology, Tokyo Postal Service Agency, Hospital, Fujimi, Chiyoda-ku, Tokyo 102-8798, Japan.
Abstract
PURPOSE: To study the diabetic retinopathy (DR) and visual acuity in patients with end-stage diabetic nephropathy in the predialysis period and the changes after the initiation of hemodialysis at Tokyo Postal Service Agency Hospital (TPSAH). METHODS: We retrospectively analyzed the systemic conditions and the stage of DR and visual acuity in the medical records, of 24 patients 48 eyes (male: female=20 : 4) with diabetic nephropathy, who were started on hemodialysis between June 1994 and August 2003 at TPSAH, and were followed ophthalmologically more than 6 months after the start of hemodialysis. RESULTS: At the start of hemodialysis, 46 of 48 eyes (95.8%) had already been treated by retinal photocoagulation. The DR activity was assessed as "low" in 62.5% of the patients at the start of hemodialysis, but 6 months later, over 95% of the patients were assessed as having "low-activity". At the start of hemodialysis visual acuity was less than 0.1 in 21% of the eyes, and over 0.7 in 42% of the eyes, and the ratio was stable in the follow-up period. In 2 eyes the stage of diabetic retinopathy became worse by more than one grade in Fukuda's grading of diabetic retinopathy, and in 4 eyes more than a 2 grade alteration in visual acuity was observed. CONCLUSIONS: After the start of hemodialysis, DR became less active relatively early, and only a few eyes became worse in visual acuity and DR.
PURPOSE: To study the diabetic retinopathy (DR) and visual acuity in patients with end-stage diabetic nephropathy in the predialysis period and the changes after the initiation of hemodialysis at Tokyo Postal Service Agency Hospital (TPSAH). METHODS: We retrospectively analyzed the systemic conditions and the stage of DR and visual acuity in the medical records, of 24 patients 48 eyes (male: female=20 : 4) with diabetic nephropathy, who were started on hemodialysis between June 1994 and August 2003 at TPSAH, and were followed ophthalmologically more than 6 months after the start of hemodialysis. RESULTS: At the start of hemodialysis, 46 of 48 eyes (95.8%) had already been treated by retinal photocoagulation. The DR activity was assessed as "low" in 62.5% of the patients at the start of hemodialysis, but 6 months later, over 95% of the patients were assessed as having "low-activity". At the start of hemodialysis visual acuity was less than 0.1 in 21% of the eyes, and over 0.7 in 42% of the eyes, and the ratio was stable in the follow-up period. In 2 eyes the stage of diabetic retinopathy became worse by more than one grade in Fukuda's grading of diabetic retinopathy, and in 4 eyes more than a 2 grade alteration in visual acuity was observed. CONCLUSIONS: After the start of hemodialysis, DR became less active relatively early, and only a few eyes became worse in visual acuity and DR.