Diabetic retinopathy in pregnancy: a 12-year prospective survey.

Horvat, Magda; MacLean, Helen E.; Goldberg, Leonard S.; Crock, G. W.

doi:10.1136/bjo.64.6.398

Cited by 87 publications

(45 citation statements)

References 11 publications

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“…Pregnancy is an independent risk factor for the worsening of diabetic retinopathy, mainly in type 1 diabetics (1). In contrast, purely gestational diabetes does not confer any risk of developing diabetic retinopathy (33).…”

Section: Diabetic Retinopathymentioning

confidence: 99%

Ocular Changes During Pregnancy

Mackensen¹,

Paulus²,

Max³

et al. 2014

Deutsches Ärzteblatt International

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Section: Diabetic Retinopathymentioning

confidence: 99%

Ocular Changes During Pregnancy

Mackensen¹,

Paulus²,

Max³

et al. 2014

Deutsches Ärzteblatt International

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“…Although some regression of nonproliferative retinopathy occurs after delivery, new cases with progression of retinopathy during pregnancy have been reported with a prevalence ranging between 20 and 85% (3)(4)(5).…”

mentioning

confidence: 99%

Increased Serum IGF-I During Pregnancy Is Associated With Progression of Diabetic Retinopathy

et al. 2003

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The IGF system has been associated with development and progression of diabetic retinopathy. We examined whether a simple measurement of the IGF system (serum total IGF-I) correlated with progression of diabetic retinopathy in pregnancy in type 1 diabetes. A prospective observational study was performed in 103 pregnant women with type 1 diabetes. Serum IGF-I was measured in maternal serum from week 14, every fourth week until week 30, and every second week until delivery. Twenty-four-hour blood pressure was measured with a portable oscillometry monitor. The women had visual acuity testing and fundus photography before pregnancy, once in each trimester, and 4 months after birth. Each eye was assigned an overall retinopathy grade on a scale from 1 to 6 independently by two experienced graders. During pregnancy, serum IGF-I increased with increasing gestational age until a plateau was reached in week 32. Progression of retinopathy was significantly associated with a higher level of IGF-I (P < 0.01). Serum IGF-I increased with increasing progression of retinopathy. Change of retinopathy was significantly associated with level of IGF-I (P < 0.01). During pregnancy, serum IGF-I increased with increasing birth weight until a plateau was reached in week 32. Birth weight was significantly associated with a higher level of serum IGF-I (P < 0.01).

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“…However, there may be up to a 50% decrease in the rate of progression in women who have laser photocoagulation prior to conception. Interestingly, proliferative retinopathy may regress at the end of the third trimester or postpartum without treatment [45,46]. However, current guidelines from the American Diabetes Association regarding severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy suggest that vigorous aerobic or resistance exercise may be contraindicated.…”

Section: Effect Of Pregnancy On Preexisting Ocular Disordersmentioning

confidence: 99%

“…It is recommended that ophthalmic examination should increase in frequency to once every trimester. Severe nonproliferative diabetic retinopathy prior to conception may result in increased retinal changes such as blot hemorrhages and cotton wool spots during the second trimester, with possible regression in the postpartum [46]. Ophthalmic examination is recommended every 2 to 3 months because this group has the highest risk of developing proliferative diabetic retinopathy [44].…”

Section: Effect Of Pregnancy On Preexisting Ocular Disordersmentioning

confidence: 99%