Abstract
Abstract: :
Purpose:To measure retinal capillary blood flow in patients with insulin-dependent diabetes mellitus (IDDN) during pregnancy and the early pospartum period. Methods:Fifty four IDDM patients and 12 healthy conrols were prospectively followed during pregnancy and 3 to 6 months postpartum.Retinal capillary blood flow was measured from three 10x10 pixel areas located at the inferior perimacular retina using the Heidelberg Retinal Flowmeter. Diabetic retinopathy status was graded from fundus photographs in a masked fashion.Fourteen of the IDDM subjects had no or minimal retinopathy at baseline Any deterioration (including an increase in microaneurysm count without change in grade) in retinopathy occurred in 20 subjects with proliferative changes occurring in 4 patients Results:In IDDM subjects the flow values (the 75th percentile of pointwise analysis) were 375 (SD=117) units during the first trimester, 392 (82) in the third trimester and 370 (77) 3 months postpartum. In healthy pregnant women the corresponding values were 324 (57) at the first trimester, 301 (36) at the third trimester and 307 (57) three months postpartum (p=0.004, ANOVA, between the groups). Flow values tended to increase somewhat more in IDDM subjects with longer duration of diabetes,or more severe retinopathy, but there were no statistically significant differences. Conclusion:Retinal capillary blood flow is elevated in patients with IDDM during pregnancy and the postpartum period, compared to healthy pregnant women. Hyperdynamic retinal capillary circulation may contribute to the development of diabetic retinopahty in these patients.
Keywords: 388 diabetic retinopathy • 331 blood supply • 554 retina