Macular Choroidal Thickness in Pregnant Women with Type 1, Type 2, and Gestational Diabetes Mellitus

Abstract

Pregnancy is an independent risk factor for the progression of diabetic retinopathy (DR). A possible relation with morphological changes of the choroid should be studied. The aim of this study was to analyze choroidal thickness measurements of nondiabetic pregnant women and of pregnant women with type 1, type 2 and gestational diabetes mellitus using spectral-domain optical coherence tomography (OCT). This cross-sectional study included 144 eyes of 72 pregnant women in the third trimester divided into four groups: Group 1 consisted of 27 nondiabetic pregnant women (control group); Group 2 consisted of 15 pregnant women with gestational diabetes mellitus (GDM); Group 3 consisted of 16 pregnant women with type 2 diabetes mellitus (T2DM); and Group 4 consisted of 14 pregnant women with type 1 diabetes mellitus (T1DM). Choroidal thickness was measured using EDI-OCT at ten different locations: at the fovea and every 500µm from the fovea up to 2500µm temporally and up to 2000µm nasally. Other variables such as gestational age, glycosylated hemoglobin values (HbA1c), time from DM diagnosis, hypertension and severity of DR were analyzed. The analysis of the 4 groups adjusted for the presence of hypertension showed a thinner choroid in patients with T1DM in all locations, with statistical significance in subfoveal and temporal measurements. In the comparison only between patients with DM, adjusted for HbA1c, time from diagnosis and presence of hypertension and DR, choroid of patients with T1DM remained thinner at all macular points. In conclusion, our study showed no statistically difference in choroidal thickness between nondiabetic pregnant women, pregnant women with GDM and pregnant women with T2DM during the third trimester. On the other hand, pregnant women with T1DM had significantly thinner choroidal thickness measurements. Disclosure C.Z. Benfica: None. T. Zanella: None. L.B. Farias: None. M.R. Oppermann: None. L.H.S. Canani: None. D. Lavinsky: None.