Acute macular edema and peripapillary soft exudate after pancreas transplantation with accelerated progression of diabetic retinopathy

Fang Yi Tsai, Ling Ing Lau, An Fei Li, Shih Jen Chen, Shin E. Wang, Fenq Lih Lee, Catherine Jiu Lin Liu, Yi Ming Shyr

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background The effect of pancreas transplantation on diabetic retinopathy remains inconclusive. Herein, we report six patients with type 1 diabetes mellitus (DM) who underwent pancreas transplantation and developed acute macular edema and peripapillary soft exudate with rapid progression to proliferative diabetic retinopathy. Methods In this retrospective observational study, diabetic patients who underwent pancreas transplantation in a single medical center and developed symptomatic acute macular edema and peripapillary soft exudate within 3 months after the operation were enrolled. The complete ophthalmic course and medical records of the patients were retrospectively reviewed. Diabetic retinopathy and progression following treatment after pancreas transplantation were measured. Results Six Chinese women with type 1 DM were enrolled in this study. Mean hemoglobin (Hb) A1c was 13.4% prior to transplantation and decreased rapidly to 6.5% within 2 months postsurgery. The patients had no or mild pretransplant diabetic retinopathy and developed acute symptomatic macular edema and peripapillary soft exudate in both eyes after pancreas transplantation. All macular edema resolved either with or without treatment. Five cases progressed to proliferative diabetic retinopathy and received panretinal photocoagulation. Diabetic retinopathy remained stable in all eyes after treatment, and the visual prognosis was good, except in one eye that had macular branch retinal artery occlusion with foveal involvement. Conclusion Acute macular edema after pancreas transplantation has a favorable treatment outcome despite rapid progression to proliferative diabetic retinopathy. High pretransplant HbA1c and abrupt blood sugar normalization may be related to the disease course.

Original languageEnglish
Pages (from-to)319-325
Number of pages7
JournalJournal of the Chinese Medical Association
Volume80
Issue number5
DOIs
Publication statusPublished - May 1 2017

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Pancreas Transplantation
Macular Edema
Diabetic Retinopathy
Exudates and Transudates
Type 1 Diabetes Mellitus
Retinal Artery Occlusion
Light Coagulation
Medical Records
Observational Studies
Blood Glucose
Hemoglobins
Therapeutics
Retrospective Studies
Transplantation

Keywords

  • diabetic retinopathy
  • hemoglobin A1c
  • macular edema
  • pancreas transplantation
  • soft exudate

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Acute macular edema and peripapillary soft exudate after pancreas transplantation with accelerated progression of diabetic retinopathy. / Tsai, Fang Yi; Lau, Ling Ing; Li, An Fei; Chen, Shih Jen; Wang, Shin E.; Lee, Fenq Lih; Liu, Catherine Jiu Lin; Shyr, Yi Ming.

In: Journal of the Chinese Medical Association, Vol. 80, No. 5, 01.05.2017, p. 319-325.

Research output: Contribution to journalArticle

Tsai, Fang Yi ; Lau, Ling Ing ; Li, An Fei ; Chen, Shih Jen ; Wang, Shin E. ; Lee, Fenq Lih ; Liu, Catherine Jiu Lin ; Shyr, Yi Ming. / Acute macular edema and peripapillary soft exudate after pancreas transplantation with accelerated progression of diabetic retinopathy. In: Journal of the Chinese Medical Association. 2017 ; Vol. 80, No. 5. pp. 319-325.
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AU - Lau, Ling Ing

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AU - Wang, Shin E.

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AU - Liu, Catherine Jiu Lin

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N2 - Background The effect of pancreas transplantation on diabetic retinopathy remains inconclusive. Herein, we report six patients with type 1 diabetes mellitus (DM) who underwent pancreas transplantation and developed acute macular edema and peripapillary soft exudate with rapid progression to proliferative diabetic retinopathy. Methods In this retrospective observational study, diabetic patients who underwent pancreas transplantation in a single medical center and developed symptomatic acute macular edema and peripapillary soft exudate within 3 months after the operation were enrolled. The complete ophthalmic course and medical records of the patients were retrospectively reviewed. Diabetic retinopathy and progression following treatment after pancreas transplantation were measured. Results Six Chinese women with type 1 DM were enrolled in this study. Mean hemoglobin (Hb) A1c was 13.4% prior to transplantation and decreased rapidly to 6.5% within 2 months postsurgery. The patients had no or mild pretransplant diabetic retinopathy and developed acute symptomatic macular edema and peripapillary soft exudate in both eyes after pancreas transplantation. All macular edema resolved either with or without treatment. Five cases progressed to proliferative diabetic retinopathy and received panretinal photocoagulation. Diabetic retinopathy remained stable in all eyes after treatment, and the visual prognosis was good, except in one eye that had macular branch retinal artery occlusion with foveal involvement. Conclusion Acute macular edema after pancreas transplantation has a favorable treatment outcome despite rapid progression to proliferative diabetic retinopathy. High pretransplant HbA1c and abrupt blood sugar normalization may be related to the disease course.

AB - Background The effect of pancreas transplantation on diabetic retinopathy remains inconclusive. Herein, we report six patients with type 1 diabetes mellitus (DM) who underwent pancreas transplantation and developed acute macular edema and peripapillary soft exudate with rapid progression to proliferative diabetic retinopathy. Methods In this retrospective observational study, diabetic patients who underwent pancreas transplantation in a single medical center and developed symptomatic acute macular edema and peripapillary soft exudate within 3 months after the operation were enrolled. The complete ophthalmic course and medical records of the patients were retrospectively reviewed. Diabetic retinopathy and progression following treatment after pancreas transplantation were measured. Results Six Chinese women with type 1 DM were enrolled in this study. Mean hemoglobin (Hb) A1c was 13.4% prior to transplantation and decreased rapidly to 6.5% within 2 months postsurgery. The patients had no or mild pretransplant diabetic retinopathy and developed acute symptomatic macular edema and peripapillary soft exudate in both eyes after pancreas transplantation. All macular edema resolved either with or without treatment. Five cases progressed to proliferative diabetic retinopathy and received panretinal photocoagulation. Diabetic retinopathy remained stable in all eyes after treatment, and the visual prognosis was good, except in one eye that had macular branch retinal artery occlusion with foveal involvement. Conclusion Acute macular edema after pancreas transplantation has a favorable treatment outcome despite rapid progression to proliferative diabetic retinopathy. High pretransplant HbA1c and abrupt blood sugar normalization may be related to the disease course.

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