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A. M. mensah, B. Sander, A.-S. Svanbom, A. Ahmadzadeh, L. Ringholm, E. Mathiesen, M. Larsen; Retinal Artery and Vein Diameters Adaptation to Glycemic and Blood Pressure Regulation During Pregnancy in Women With Type 1 Diabetes. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5064.
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Pregnancy is associated with increased risk of short-term development and progression of diabetic retinopathy. It is suspected that changes in circulation, blood pressure, glycemia, and pregnancy-related hormones may be involved. The aim of this study was to assess retinal artery and vein diameters in relation to glycemia and blood-pressure regulation before, during, and after pregnancy in women with diabetes.
Retrospective study of disk-centered 50 degree digital color fundus photographs and clinical records from 60 patients with type 1 diabetes.
HbA1c decreased from 7.28±1.02 % (mean±SD) one year before pregnancy to 6.23±0.67 % (p<0.0001) by the end of the first trimester and 5.92±0.43 % (p<0.0001) by the end of the third trimester. Systolic blood pressure was 122.4±9.8 mmHg late in the first trimester and 124.3±11.9 mmHg late in the third trimester (p=0.53) while the corresponding values for diastolic blood pressure were 72.2±7.7 mmHg and 77.0±5.6 mmHg (p=0.0001). Retinal artery diameter constricted from 132.0±18.5 µm before pregnancy to 125.4±14.9 µm by the end of the first trimester (p=0.012) and a concomitant constriction occurred in the retinal veins, from 191.9±28.0 µm to 180.4±25.4 µm (p=0.0035). No significant changes were seen from the first to the third trimester. After delivery, both arteries and vein dilated to near pre-pregnancy values.
Retinal arteries and veins constricted early in pregnancy in women with diabetes and dilated again after delivery. This early constriction coincided with the steep initial reduction of glycemia and increased diastolic blood pressure.
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