Background: According to statistics, microvascular complications of diabetes mellitus (DM) are registered in a third of patients during their lifetime, and DR is the main cause of irreversible blindness in people of reproductive age. Currently, changes in the vascular membrane in patients with DM are being actively studied as a predictor of the progression of diabetic retinopathy. Additional study of changes in the vascular membrane in pregnant women with type 1 and type 2 diabetes may help to identify criteria for the manifestation and progression of diabetic microangiopathy.
Aims: to develop an algorithm for predicting the risk of progression of the disease.
Methods: The study was conducted in each trimester of pregnancy. A pregnant patient with a previously established and documented diagnosis of DM1 or DM2 underwent a comprehensive ophthalmological examination, including visometry with maximally corrected visual acuity (MCOZ), tonometry, biomicroscopy of the anterior segment of the eye, ophthalmoscopy under conditions of drug-induced mydriasis (phenylephrine) with a high-diopter lens (78-90D), anterior and posterior OCT (A-OCT) eye segments.
Results: During the study, it was revealed that with an increase in the thickness of the vascular layer of the ciliary body by 10% or more at 1 or more points compared with the study conducted in the first trimester of pregnancy, during subsequent routine examinations, patients with this type of changes in the vascular layer of the CT showed signs of progression of DR. Quantitative analysis of the vascular layer of CT additionally determined the transition to the next stage of DR, when the method of photoregistration of the fundus had not yet determined obvious signs of transformation into another stage of the disease. Correlation analysis showed the presence of a strong direct correlation between the size of the vascular layer of CT and the progression of diabetic retinopathy (r =-087; p0.05) (r =-0.78; p0.05).
Conclusions: The dynamic study of the proposed parameters during gestation provides an increase in the accuracy of the prognosis of the risk of progression due to an objective predictor of the prognostic assessment of the course of the disease – the threshold value of the change in the thickness of the vascular layer of the ciliary body from the initial value.
