Investigation of diabetic retinopathy progression in women with diabetes mellitus during pregnancy

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PURPOSE

The study evaluates the transient and stationary diabetic retinal changes in pregnant women with diabetes mellitus (DM) based on the analysis of individual clinical cases of diabetic retinopathy (DR) progression.

MATERIAL AND METHODS

The study examined 24 pregnant women with DM. The examination was carried out in each trimester of pregnancy and 6 months after delivery. In 10 pregnant women DR was not detected, and 14 (58%) were diagnosed with DR.

RESULTS

Progression of DR during pregnancy was observed in 9 patients with pre-proliferative and proliferative DR (PPDR and PDR) and uncompensated glycemia, 3 patients developed macular edema (ME) in both eyes. Panretinal laser coagulation (PRLC) was performed in patients with ongoing DR progression. In the postpartum period, the manifestations of DR did not regress. ME turned out to be transient in one patient with PPDR. Three clinical cases of DR manifesting in the first trimester of pregnancy are presented: PPDR with transient ME, PDR with ME, non-proliferative DR with a stable course.

CONCLUSION

1. DR detected at the beginning of gestation in women with decompensated glycemic status progressed in 64% of cases. 2. Progression of DR during pregnancy was noted in patients with PPDR and PDR. 3. Progression of DR during pregnancy is more often true than transient. 4. Detection of PPDR and PDR during pregnancy is a direct indication for laser coagulation of the retina.

Keywords:

transient retinopathy

diabetic retinopathy

pregnancy

intensive insulin therapy

OCT angiography

Authors:

Pomytkina N.V.

Khabarovsk branch of S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”;
Far-Eastern State Medical University

ORCID: 0000-0001-8161-8643

Sorokin E.L.

Khabarovsk branch of S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”;
Far-Eastern State Medical University

ORCID: 0000-0002-2028-1140

Received:

16.01.2023

Accepted:

09.03.2023

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