Current Trends in Diagnosis and Treatment Approach of Diabetic Retinopathy during Pregnancy: A Narrative Review

Abstract

Diabetes mellitus during pregnancy and gestational diabetes are major concerns worldwide. These conditions may lead to the development of severe diabetic retinopathy during pregnancy or worsen pre-existing cases. Gestational diabetes also increases the risk of diabetes for both the mother and the fetus in the future. Understanding the prevalence, evaluating risk factors contributing to pathogenesis, and identifying treatment challenges related to diabetic retinopathy in expectant mothers are all of utmost importance. Pregnancy-related physiological changes, including those in metabolism, blood flow, immunity, and hormones, can contribute to the development or worsening of diabetic retinopathy. If left untreated, this condition may eventually result in irreversible vision loss. Treatment options such as laser therapy, intravitreal anti-vascular endothelial growth factor drugs, and intravitreal steroids pose challenges in managing these patients without endangering the developing baby and mother. This narrative review describes the management of diabetic retinopathy during pregnancy, highlights its risk factors, pathophysiology, and diagnostic methods, and offers recommendations based on findings from previous literature.

Aldose Reductase as a Key Target in the Prevention and Treatment of Diabetic Retinopathy: A Comprehensive Review

“…Measurement of aldose reductase in DR involves various techniques aimed at assessing its activity and expression levels within retinal tissues or biological solutions obtained from patients. Enzymatic assays represent a direct method for quantifying AR activity, typically involving the detection of the conversion of glucose to sorbitol, by the increased activity of aldose reductase in DM patients [9,51]. Immunohistochemical staining techniques [52,53] and spectrophotometric tests may allow quantification of aldose reductase expression [54].…”

“…Prolonged duration of diabetes, poor glycemic control, hypertension (both systemic and ocular), dyslipidemia, cigarette smoking, and genetic susceptibility are among the most significant factors [7]. Additionally, pregnancy can exacerbate DR, particularly in women with pre-existing diabetes; therefore, pre-conceptional care is needed [9].…”

Immune-Mediated Ocular Surface Disease in Diabetes Mellitus—Clinical Perspectives and Treatment: A Narrative Review

“…Pharmacological medication for diabetes should be the initial treatment for corneal neuropathy in order to achieve precise blood glucose control. Systemic therapy is the most important tool for treating DM and preventing its complications when lifestyle and diet changes are not effective [ 86 ]. Effective management must limit further advancement of corneal neuropathy.…”

Risk Factors of Thrombophilia-Related Mutations for Early and Late Pregnancy Loss

“…The causes of recurrent miscarriage are multifaceted, including genetic, anatomical, hormonal, immunological, and environmental factors [2][3][4][5][6]. Among these, genetic factors, particularly thrombophilia, have garnered significant attention due to their potentially treatable nature and impact on pregnancy outcomes.…”