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L. Stalnikiewicz, A. Sayen, B. Guerci, K. Angioi Duprez; Progression of Diabetic Retinopathy During Pregnancy: A Retrospective Analysis of 77 Consecutive Patients. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5050.
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To assess diabetic retinopathy progression during pregnancy and to determine predictive factors of it progression.
Retrospective study including 77 consecutive diabetic women submitted to a multidisciplinary medical follow-up during pregnancy with at least one ophthalmologic examination per trimester with ocular fundus photographies.
A diabetic retinopathy was evidenced in 27,3% of the patients during the 1st trimester (no proliferative form), in 28,6% during the 2nd (2 proliferative forms) and 31,2% during the 3rd (2 proliferative forms). Progression of at least 1 grade was evidenced in 4 patients from the 1st to the 2nd trimester, in 3 from the 2nd to the 3rd, and finally 7 patients during the overall follow-up period. Two patients showed progression to a proliferative form from the 1st to the 2nd trimester. We failed to identify any predictive factor of diabetic retinopathy progression except when combining prior systemic hypertension and pregnancy-induced hypertension (p<0,03).
The results of our study confirm that diabetic retinopathy progression is uncommon during pregnancy especially if diabetic retinopathy is absent or mild at the beginning. Optimal glycemic and blood pressure controls play a major role to prevent diabetic retinopathy progression. Collaborative medical follow-up allows to minimize ophthalmologic impairment during pregnancy.
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