Pregnancy and diabetic retinopathy – screening and therapy: case report


Authors: Mária Molnárová
Authors‘ workplace: VIKOM, s. r. o., 1. žilinské očné centrum, Žilina
Published in: Forum Diab 2013; 2(3): 176-180
Category: Main Theme: Case Report

Overview

Pregnancy can very adversely affect the formation or progression of diabetic retinopathy (DR). Fertile women with diabetes mellitus (DM) should be informed about risk of formation and progression of diabetic retinopathy during pregnancy. Also they should be educated about the importance of good glycemic control of diabetes and ocular finding before conception and during pregnancy. Ophtalmological examination and laser treatment of DR should be realized before conception and then in 1 trimester of pregnancy again. Further follow-up and possibly laser treatment will depend on the presence / absence of changes in terms of DR and its severity.

The case of our patient – planned pregnancy, improved glycemic control of DM and DR laser treatment before conception and during pregnancy enabled to stabilize diabetic retinopathy before pregnancy, maintain so called steady state of DR and normal visual function throughout whole pregnancy, after delivery, until now.

Key words:
diabetic retinopathy – laser treatment DR – pregnancy – screening DR


Sources

1. Ray JG, O´Brien TE, Chan WS. Preconception care and risk of congenital anomalies in the offspring of women with diabetes mellitus: a meta-analysis. QJM 2001; 94(8): 435–444.

2. Temple R, Aldridge V, Greenwood R et al. Association between outcome of pregnancy and glycaemic control in early pregnancy in type 1 diabetes: population based study. BMJ 2002; 325(7375): 1275–1276.

3. Schocket LS, Grunwald JE, Tsang AF et al. The effects of pregnancy on retinal hemodynamics in diabetic versus nondiabetic mothers. Am J Ophthalmol 1999; 128(4): 477–484.

4. Larsen M, Colmorn LB, Bønnelycke M et al. Retinal artery and vein diameters during pregnancy in diabetic women. Invest Ophthalmol Vis Sci 2005; 46(2): 709–713.

5. Chen HC, Newsom RS, Patel V et al. Retinal blood flow changes during pregnancy in women with diabetes. Invest Ophthalmol Vis Sci 1994; 35(8): 3199–3208.

6. Loukovaara S, Harju M, Kaaja R et al. Retinal capillary blood flow in diabetic and nondiabetic women during pregnancy and postpartum period. Invest Ophthalmol Vis Sci 2003; 44(4): 1486–1491.

7. Kinshuck D. Pregnancy and diabetic retinopathy. On-line 2008. Dostupné z WWW: .

8. Chew EY, Mills JL, Metzger BE et al. Metabolic control and progression of retinopathy. The Diabetes in Early Pregnancy Study. Diabetes Care 1995; 18(5): 631–637.

9. Klein BE, Davis MD, Segal P et al. Diabetic retinopathy. Assessment of severity and progression. Ophthalmology 1984; 91(1): 10–17.

10. Diabetic Retinopathy Study Research Group. Four risk factors for severe visual loss in diabetic retinopathy. Arch Ophthalomol 1979; 97(4): 654–655.

11. Stoessel KM, Liao PM, Thompson JT et al. Diabetic retinopathy and macular edema in pregnancy. Ophthalmology 1991; 98(9, Suppl): 146.

12. Early Treatment Diabetic Retinopathy Study Research Group. Treatment techniques and clinical guidelines for photocoagulation of diabetic macular edema. Report Number 2. Ophthalmology 1987; 94(7): 761–774.

13. The American Academy of Ophthalmology. Diabetic Retinopathy. Preferred Practice Patterns. San Francisco (CA) 2003. Dostupné z WWW: <http://one.aao.org/guidelines-browse?filter= preferredpracticepatterns>.

14. The Saint Vincent Declaration. Diabetes Mellitus in Europe: a problem at all ages and in all countries. A Model for Prevention and Self Care. Meeting WHO a IDF, Saint Vincent, Italy, 10.-12. 10. 1989. Dostupné z WWW:<http://www.dors.it/diabete/docum/SaintVincentDeclaration_1989_.pdf>.

Labels
Diabetology Endocrinology Internal medicine
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