Hemoperfusion and functional state of the macula after simultaneous pancreas and kidney transplantation

Simultaneous pancreas and kidney transplantation (SPK) provides effective treatment in patients with type 1 diabetes mellitus (T1DM) and end-stage renal failure (ESRF), mitigating the hyperglycemia and uremic syndrome. The study aimed at the assessment of morphofunctional status of the macula and macular hemodynamics in patients with T1DM after SPK. The study enrolled 45 patients subdivided into three groups: Group A — patients with T1DM after SPK; Group B — patients with T1DM and ESRF, maintained on programmed hemodialysis (PH), on waiting list for SPK; and Group C — individuals without ophthalmic or systemic pathologies. All patients were subject to the standard ophthalmological examination complemented by measurements of the central retinal thickness (CRT) and the average perfusion density (PD) in four vascular layers: superficial capillary plexus of the retina (SCP), deep capillary plexus of the retina (DCP), choriocapillaris, and choroid. The patients after SPK had significantly lower CRT (241 ± 33 µm in Group A, 309±10 µm in Group B; p &lt; 0.05) and significantly higher PD of the macular region in both the retina (Group A: SCP — 19.0 ± 1.6%, DCP — 10.7 ± 1.3%; Group B: SCP — 11.7 ± 0.8%, DCP — 4.8 ± 0.8%; p &lt; 0.05) and the choroid (Group A: choriocapillaris — 28.1 ± 1.8%, choroid — 31.3 ± 1.6%; Group B: choriocapillaris — 20.4 ± 1.6%, choroid — 21.8 ± 1.3%; p &lt; 0.05), as well as significantly higher visual acuity (Group A: 0.7 ± 0.1; Group B: 0.5 ± 0.1; p &lt; 0.05) and macular light threshold (Group A: 25.9 ± 1.4 dB; Group B: 22.3 ± 1.1 dB; p &lt; 0.05) compared with the patients on PH. Thus, the normalization of carbohydrate metabolism and the mitigation of uremic syndrome in patients with T1DM and ESRF after SPK favorably affect the functional condition of the macular area, as indicated by the improvement in macular blood flow and visual functions.</jats:p

MicroRNA and vascular pathology of the eye

Since the discovery of microRNAs just a few decades ago, our knowledge of these molecules and their potential as diagnostic biomarkers and therapeutic targets has significantly expanded. There is an ongoing discussion in the scientific community about the possibility of using microRNA for the diagnosis of cardiovascular diseases. It has been shown recently that levels of some microRNAs vary in vascular eye disorders, such as age-related macular degeneration and diabetic retinopathy. However, despite serious advances in our understanding of microRNA’s role in eye pathology, we still do not know whether it is possible to use microRNA as a biomarker for central retinal vein occlusion. Perhaps, the discovery of such candidate microRNAs will help in making the timely diagnosis and improve the quality of medical care in patients with retinal vein occlusion.</jats:p