Diabetic retinopathy in pregnancy: a review

Morrison, Julie; Hodgson, Lauren; Al-Qureshi, Salmaan

doi:10.1111/ceo.12760

Cited by 92 publications

(116 citation statements)

References 55 publications

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“…In addition, there is an increased risk of postpartum worsening of DR 6-12 months after birth has been given (DCCT 2000; Morrison et al 2016). In addition, there is an increased risk of postpartum worsening of DR 6-12 months after birth has been given (DCCT 2000; Morrison et al 2016).…”

Section: Pregnancymentioning

confidence: 99%

“…Risk factors for DR worsening in pregnancy include long duration of diabetes, high blood sugar, fast glycaemic improvement, high blood pressure, elevated serum cholesterol, impaired kidney function and high level of pre-existing DR. In addition, there is an increased risk of postpartum worsening of DR 6-12 months after birth has been given (DCCT 2000; Morrison et al 2016).…”

Section: Pregnancymentioning

confidence: 99%

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Evidence‐based Danish guidelines for screening of diabetic retinopathy

Grauslund

Andersen

Andresen

et al. 2018

Acta Ophthalmologica

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Purpose: Diabetic retinopathy (DR) is among the leading causes of visual loss in the working-age population. It is generally accepted that screening of DR is costeffective and can detect DR before it becomes sight-threatening to allow timely treatment. Methods: A group of retinal specialists was formed by the Danish Ophthalmological Society with the aim to formulate contemporary evidence-based guidelines for screening of DR in order to implement these in the Danish screening system. Results: We hereby present evidence for DR-screening regarding (1) classification of DR, (2) examination techniques, (3) screening intervals and (4) automated screening. It is our recommendation that the International Clinical Retinopathy Disease Severity Scale should be used to classify DR. As a minimum, mydriatic two-field disc-and macular-centred images are required. In the case of suspected clinically significant diabetic macular oedema, supplementary optical coherence tomography can increase the diagnostic accuracy. There is solid evidence to support a flexible, individualized screening regimen. In particular, it is possible to prolong screening intervals to 24-48 months for patients with no or mild nonproliferative diabetic retinopathy (NPDR), but it is also possible to use extended intervals of 12-24 months for patients with moderate NPDR given that these are well-regulated regarding glycaemic control (HbA1c ≤ 53 mmol/mol) and blood pressure (≤130/80 mmHg). Automated screening of DR is encouraging but is not ready for implementation at present. Conclusion: Danish evidenced-based guidelines for screening of DR support high-quality imaging and allow flexible, individualized screening intervals with a potential for extension to patients with low risk of DR progression.

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Section: Pregnancymentioning

confidence: 99%

Section: Pregnancymentioning

confidence: 99%

Evidence‐based Danish guidelines for screening of diabetic retinopathy

Grauslund

Andersen

Andresen

et al. 2018

Acta Ophthalmologica

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“…The highest rate of diabetes in pregnancy is recorded in Southeast Asia, 25%, and the prevalence of pre-existing diabetes is highest among women from the Middle East and North Africa-3.1%. Australian mothers who were born in high diabetes risk areas such as Polynesia, Asia, and the Middle East are 1.4 times more likely to have type 2 diabetes during pregnancy [45]. Similarly, in the USA and UK, patients belonging to Black, Asian, Hispanic, and Pacific Island ethnic minorities had higher proportion of pre-existing diabetes and pre-existing type 2 DM.…”

Section: Pregnancy In Diabetic Patientsmentioning

confidence: 99%

Diabetic Retinopathy and Blindness: An Epidemiological Overview

Pandova¹

2020

Visual Impairment and Blindness - What We Know and What We Have to Know

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Prevalence of diabetes is rising worldwide. In the course of the last 20 years, blindness and low vision due to diabetic eye complications have increased in large regions in Eastern Europe, North Africa/Middle East, Asia, Latin America, and Oceania. The magnitude and trends of vision-threatening disease are presented. Systemic risk factors for progression to sight-threatening disease are reviewed. The impact of economic and cultural background on early diagnosis and adherence to treatment is highlighted. Current management of diabetic macular edema, proliferative diabetic retinopathy, neovascular glaucoma, and cataract surgery of diabetic patients is outlined, and its contribution to preventing vision loss is reviewed.

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“…3 Pregnancy is a major and independent risk factor for the progression of the disease. [2][3][4]8 There are other risk factors known, [1][2][3]8,23 such as the duration of the disease, 2 metabolic control before and during pregnancy 2,3 (normoglycemia prior to pregnancy improves the outcome, and poor control increases the progression, as well as a rapid normalization of blood glucose levels during pregnancy, 2,24 although it is not a reason for suboptimal diabetes control in this period), 24 insulin therapy, visual acuity and macular edema before pregnancy, 3,24 the severity of the disease at conception, 2,8 the coexistence of hypertension 2,24 and PE, 24,25 and changes in retinal flow. Glycemic control during pregnancy is associated with decreased risk of fetal macrosomia and congenital malformation.…”

Section: Diabetic Retinopathymentioning

confidence: 99%

Ocular Changes During Pregnancy

Marcos-Figueiredo

Menéres

et al. 2017

Rev Bras Ginecol Obstet

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Pregnancy is needed for the perpetuation of the human species, and it leads to physiological adaptations of the various maternal organs and systems. The eye, although a closed space, also undergoes some modifications, most of which are relatively innocuous, but they may occasionally become pathological. For women, pregnancy is a susceptibility period; however, for many obstetricians, their knowledge of the ocular changes that occur during pregnancy tends to be limited. For this reason, this is a important area of study as is necessary the development of guidelines to approach those changes. Of equal importance are the knowledge of the possible therapies for ophthalmological problems in this period and the evaluation of the mode of delivery in particular conditions. For this article, an extensive review of the literature was performed, and a summary of the findings is presented.

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Diabetic retinopathy in pregnancy: a review

Cited by 92 publications

References 55 publications

Evidence‐based Danish guidelines for screening of diabetic retinopathy

Evidence‐based Danish guidelines for screening of diabetic retinopathy

Diabetic Retinopathy and Blindness: An Epidemiological Overview

Ocular Changes During Pregnancy

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