Course of diabetic retinopathy before and after renal transplantation.

Dear Editor,

We read with interest the article titled “The effects of renal transplantation on diabetic retinopathy: Clinical course and visual outcomes.”[1]

We would like to comment on a few observations we made on reading this article.

We are all aware that a good metabolic control plays a vital role in the slow progression of diabetic retinopathy. There are other risk factors like lipid profile, blood sugar levels, hemoglobin, and blood pressure, which too would have an effect on the progression of the diabetic retinopathy. However, in this article, the metabolic status of the patients before and after renal transplantation has not been mentioned[23]

The second observation is that the status of the diabetic macular edema has not been mentioned before and after renal transplantation, which would have maximum correlation with the improvement in visual acuity post renal transplantation

Furthermore, documentation with color fundus photographs would have made the grading of diabetic retinopathy more objective and avoided subjective variation

The improvement in diabetic retinopathy has not been defined, and the number of patients in each follow-up quartile of the study is not mentioned.

It is an interesting observation made in this study of the role of renal transplantation on progression of diabetic retinopathy. However, a prospective study with all metabolic parameters defined and color fundus photographs documentation would be more valuable.