Occurrence and Prognostic Significance of Retinopathy in Diabetic Pregnancy

Laatikainen, Leila; J, Larinkari; Teramo, Kari; Ko, Raivio

doi:10.1097/00006254-198111000-00008

Cited by 5 publications

(14 citation statements)

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“…The results of several studies suggest that pregnancy in type I diabetic women may aggravate DR [83,[85][86][87][88][89][90]. During pregnancy, it is unclear to what extent the irreversible component of DR progression is caused by pregnancy per se or whether this component merely reflects the natural history of a progressive disease.…”

Section: Mechanisms Of Progression Of Diabetic Reti-nopathy During Prmentioning

confidence: 99%

“…These spots develop in some type I diabetic women with BDR during advancing pregnancy. Postpartum, they usually regress, unlike the lesions that are characteristic of the pre-proliferative stage of DR such as intraretinal microvascular abnormalities (IRMA) [85]. Lastly, pre-existing PDR can show progressive deterioration during pregnancy [86].…”

Section: Natural Course Of Dr During Pregnancymentioning

confidence: 99%

“…Duration of diabetes before conception is the prime risk factor as regards the presence, severity and progression of DR during pregnancy [83,85,87,101,145,[152][153][154][155]. Other crucial factors for the progression of DR during pregnancy are chronic and pregnancy-induced hypertension (PIH) [14,132,156], hyperglycaemia [129,130,132], poor glycemic control of diabetes at conception [131,132,154], and stage of DR at baseline [64,131,145,150,[155][156][157][158][159].…”

Section: Risk Factors Associated With the Progression Of Drmentioning

confidence: 99%

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Progression of Retinopathy in Type 1 Diabetic Women During Pregnancy

Kaaja¹,

Loukovaara

2007

CDR

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Progression of diabetic retinopathy (DR) occurs at least temporarily during pregnancy and postpartum. The pathogenetic mechanisms of DR progression during pregnancy are not fully understood. Several factors related to metabolic changes (hyperglycaemia), diabetes itself (duration of diabetes before conception, baseline status of DR), pregnancy physiology (hypervolaemia and hypercoagulation, impaired retinal autoregulation) and pregnancy complications (pre-eclampsia) seem to play important roles in the progression of DR during pregnancy. On the other hand, systemic angiopoietic and vasoactive factors seem to have minor role in the deterioration of DR during that time period. Good glycaemic control, normotension, lack of nephropathy as well as lack of pre-proliferative/proliferative changes of DR are good prognostic factors as regards the progression of DR during pregnancy. However, pregnancy seems to have no long-term detrimental effects as regards the progression of DR unless it has proceeded to pre-proliferative and proliferative phases.

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Section: Mechanisms Of Progression Of Diabetic Reti-nopathy During Prmentioning

confidence: 99%

Section: Natural Course Of Dr During Pregnancymentioning

confidence: 99%

Section: Risk Factors Associated With the Progression Of Drmentioning

confidence: 99%

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Progression of Retinopathy in Type 1 Diabetic Women During Pregnancy

Kaaja¹,

Loukovaara

2007

CDR

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“…В другом исследовании L. Laatikainen и соавт. [19], обследовав 73 беременных с диабетом, не выявили у них значимого прогрессирования ретинопатии с отсутствием или минимальной ДР в начале беременности, но отметили ее прогрессирование у 65% пациенток с выраженной ДР в I триместре.…”

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Clinical features of diabetic retinopathy in pregnancy

Pomytkina¹,

Sorokin²

2019

Vestn. oftal'mol.

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РЕЗЮМЕВведение. Беременность является фактором риска прогрессирования диабетической ретинопатии (ДР). Несмотря на распространенное мнение о регрессе ДР после родов, возможно агрессивное течение процесса, приводящее при несвоевременном лечении к потере зрительных функций.Цель -представить клинические случаи с различным течением ДР у беременных с сахарным диабетом 1-го типа (СД1). Материал и методы. Обследовано 5 беременных, страдающих СД1 более 8 лет. У всех пациенток уровень гликемии был выше нормы (гликированный гемоглобин более 6,1%). Проводилось офтальмологическое обследование с фоторегистрацией глазного дна, оптической когерентной томографией (ОКТ) макулярной зоны, ангио-ОКТ. Результаты. Наибольшее значение в отношении прогрессирования ДР во время беременности имеют компенсация СД1, тяжесть и стабилизация ДР в преконцептуальном периоде, наличие сопутствующей патологии. Показано, что своевременное выявление признаков прогрессирования ДР и проведение лечебных мероприятий (в частности, лазеркоагуляции сетчатки) у беременных с СД1 позволяют у них стабилизировать течение заболевания и предотвратить потерю зрения. Заключение. Клиническое течение ДР при беременности вариабельно: отсутствие манифестации, стабилизация, прогрессирование. Прогрессирование ДР во время беременности определяется рядом факторов, в частности компенсацией СД в преконцептуальном периоде и на протяжении беременности, тяжестью и стабилизацией ретинопатии в преконцептуальном периоде, наличием сопутствующей патологии. Своевременное выявление признаков прогрессирования ДР и проведение лечебных мероприятий (в частности, лазеркоагуляции сетчатки) во время беременности позволяет стабилизировать течение заболевания. У части беременных возможно агрессивное течение ДР с прогрессированием в послеродовом периоде, в связи с чем требуется активное наблюдение пациенток с ретинопатией после родов.Ключевые слова: беременность, диабетическая ретинопатия, сахарный диабет, диабетическая нефропатия, лазеркоагуляция сетчатки.

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“…Improved maternal care and better metabolic control have decreased the fetal and neonatal risks in diabetic pregnancies. In spite of good control with conventional insulin therapy (CIT), progression of retinopathy may still be seen during pregnancy (1,2). In non-pregnant diabetics, the influence of improved metabolic control on retinopathy is controversial.…”

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confidence: 99%

A Controlled Study of the Influence of Continuous Subcutaneous Insulin Infusion Treatment on Diabetic Retinopathy during Pregnancy

Laatikainen

Teramo

Hieta-Heikurainen

et al. 1987

Journal of Internal Medicine

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ABSTRACT. Laatikainen L, Teramo K, Hieta‐Heikurainen H, Koivisto V, Pelkonen R (Department of Ophthalmology, I and II Departments of Obstetrics and Gynaecology, III Department of Medicine, Helsinki University Hospital, Helsinki, Finland). A controlled study of the influence of continuous subcutaneous insulin infusion treatment on diabetic retinopathy during pregnancy. Forty consecutive pregnant patients with insulin‐dependent (Type I) diabetes mellitus were randomized at the end of the first trimester for treatment with conventional insulin therapy (CIT) or continuous subcutaneous insulin infusion therapy (CSII). Nine patients randomized into the CSII group declined the pump treatment. The mean glycosylated haemoglobin (Hb A1c) decreased (p<0.001) both in the CIT and the CSII groups with no difference between the groups. Some deterioration in retinopathy was found in 2/18 patients in the CIT group, in 5/13 in the CSII group, and in 3/9 of those who declined the pump treatment. The proportion of patients whose retinopathy progressed did not differ significantly between the groups, and in the majority the deterioration was mild. However, two patients in the CSII group developed acute ischaemic retinopathy, which progressed to proliferative stage in spite of laser treatment. In these two cases the decrease in the Hb Alc level was among the greatest and fastest in the study. These data suggest that a rapid near normalization of glycaemic control by CSII during pregnancy can accelerate the progress of retinopathy in poorly controlled diabetic patients.

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Occurrence and Prognostic Significance of Retinopathy in Diabetic Pregnancy

Cited by 5 publications

References 0 publications

Progression of Retinopathy in Type 1 Diabetic Women During Pregnancy

Progression of Retinopathy in Type 1 Diabetic Women During Pregnancy

Clinical features of diabetic retinopathy in pregnancy

A Controlled Study of the Influence of Continuous Subcutaneous Insulin Infusion Treatment on Diabetic Retinopathy during Pregnancy

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