Abstract
Advanced retinopathy is one of the most crucial determinants of quality of life in diabetic patients undergoing dialysis.
To determine whether recent advances in ophthalmological treatment improve retinopathy before and after dialysis commencement, we examined 1, 304 eyes of 652 diabetic patients who started hemodialysis during 23 years.Eyes were classified into the following three groups according to the year dialysis was started in each patient: group 1: 104 eyes in 1978-1985;group 2: 456 eyes in 1986-1993;and group 3: 744 eyes in 1994-2000.Ophthalmological information obtained included history of laser photocoagulation and vitrectomy, stage of retinopathy, and visual acuity.Progression of retinopathy after dialysis commencement was also determined.
Prevalence of eyes with previous photocoagulation or vitrectomy increased gradually over time with statistical significance among the three groups.Eyes with proliferative retinopathy and those with blindness both decreased in recent years.Outcome of retinopathy after dialysis also improved significantly with three-year cumulative progression rates of 43% in group 1, 25% in group2, and 22% in group 3 (p<0.05). In conclusion, ophthalmological intervention for diabetic retinopathy has yielded less frequent advanced retinopathy and severe visual disturbance, with improved retinopathy outcome in diabetic patients undergoing dialysis in recent years.
