diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM13306diaendo-13306Research ArticleОБЗОРЫREVIEWSФакторы прогрессирования диабетической ретинопатии и развития макулярного отека после трансплантации поджелудочной железыFactors for diabetic retinopathy progression and macular edema development after pancreas transplantationhttps://orcid.org/0000-0001-9080-3170АржиматоваГ. Ш.ArzhimatovaG. S.

Аржиматова Гульжияна Шевкетовна - к.м.н., доцент.

Москва

Gulzhiyana S. Arzhimatova - PhD.

Moscow

gulzhiana.shevketovna@yandex.ruhttps://orcid.org/0000-0002-7201-3885БулаваЕ. В.BulavaE. V.

Булава Евгений Валерьевич - к.м.н., ассистент.

125993, Москва, Баррикадная ул., д. 2/1, стр. 1

Evgeniy V. Bulava - PhD, assistant.

2/1, building 1 Barrikadnaya street, 123242 Moscow

bulava.eyes@mail.ruhttps://orcid.org/0000-0002-4447-5919ГусаковМ. В.GusakovM. V.

Гусаков Михаил Владимирович - клинический ординатор.

Москва

Mikhail V. Gusakov - clinical resident.

Moscow

gmiklv@gmail.comhttps://orcid.org/0000-0002-5731-3310ДмитриевИ. В.DmitrievI. V.

Дмитриев Илья Викторович - д.м.н., доцент.

Москва

Ilya V. Dmitriev - PhD, Associate Professor.

Moscow

ildmi@mail.ruМосковский многопрофильный научно-клинический центр им. С.П. Боткина; Российская медицинская академия непрерывного профессионального образованияРоссияS.P. Botkin Clinical Hospital; Russian Medical Academy of Continuous Professional EducationRussian FederationМосковский многопрофильный научно-клинический центр им. С.П. БоткинаРоссияS.P. Botkin Clinical HospitalRussian FederationНаучно-исследовательский институт скорой помощи им. Н.В. Склифосовского; Российский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияSklifosovsky Research Institute for Emergency Medicine; Pirogov Russian National Research Medical UniversityRussian Federation202524072025283249258Copyright © Аржиматова Г.Ш., Булава Е.В., Гусаков М.В., Дмитриев И.В., 20252025Аржиматова Г.Ш., Булава Е.В., Гусаков М.В., Дмитриев И.В.Arzhimatova G.S., Bulava E.V., Gusakov M.V., Dmitriev I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/13306

Влияние трансплантации поджелудочной железы на состояние органов-мишеней при сахарном диабете (СД) является областью, которая требует дальнейшего изучения. В данном литературном обзоре проанализированы исследования, отражающие офтальмологический статус пациентов до и после трансплантации поджелудочной железы, а также произведена оценка потенциальных факторов риска, ассоциированных с прогрессированием диабетической ретинопатии и развитием диабетического макулярного отека в посттрансплантационном периоде. На основании результатов изученных исследований были выделены следующие предикторы прогрессирования диабетического поражения глазного дна после трансплантации поджелудочной железы: ранний возраст к моменту манифеста СД, непролиферативная стадия диабетической ретинопатии или отсутствие ретинопатии до хирургического лечения СД, проведение панретинальной лазерной коагуляции в течение 1 года до трансплантации, проведение изолированной трансплантации поджелудочной железы в качестве метода выбора пересадки, высокий исходный и послеоперационный уровни гликированного гемоглобина (до трансплантации — ≥9,0±2,3%, после операции — ≥6,0±0,6%), а также его выраженное снижение после хирургического лечения СД, артериальная гипотензия в первые 3 месяца после трансплантации, артериальная гипертензия в позднем посттрансплантационном периоде. Знание данных факторов риска может помочь врачу-офтальмологу в формировании прогноза течения диабетических изменений глазного дна, осуществлении профилактики, а также в оказании своевременной квалифицированной помощи при ухудшении офтальмологического статуса реципиентов трансплантата поджелудочной железы.

The effect of pancreatic transplantation on the condition of target organs in diabetes mellitus (DM) is an area that requires further study. In this literature review, studies reflecting the ophthalmological status of patients before and after pancreatic transplantation were analyzed, as well as an assessment of potential risk factors associated with the progression of diabetic retinopathy and the development of diabetic macular edema in the post-transplant period. Based on the results of the studies studied, the following predictors of the progression of diabetic fundus damage after pancreatic transplantation were identified: early age at the time of DM manifestation, absence or presence of a non-proliferative stage of diabetic retinopathy before surgical treatment of DM, panretinal laser coagulation for 1 year before transplantation, isolated pancreatic transplantation as a method of choice of transplantation, high baseline and postoperative levels of glycated hemoglobin (before transplantation — ≥9.0±2.3%, after surgery — ≥6.0±0.6%), as well as its marked decrease after surgical treatment of diabetes, arterial hypotension in the first 3 months after transplantation, arterial hypertension in the late post-transplant period. Knowledge of these risk factors can help an ophthalmologist in predicting the course of diabetic fundus changes, carrying out prevention, as well as in providing timely qualified assistance in case of deterioration of the ophthalmological status of pancreatic transplant recipients.

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The authors declare that there are no conflicts of interest present.