Factors for diabetic retinopathy progression and macular edema development after pancreas transplantation

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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