Investigative Ophthalmology & Visual Science Cover Image for Volume 60, Issue 9
July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Diabetic Retinopathy in Pregnant Women with Type I and II Diabetes in Metropolitan Melbourne – Prevalence, Adherence and Barriers to the Recommended Eye Screening Guidelines
Felicia Widyaputri; Mali Okada; Sophie Rogers; Alison Nankervis; Jennifer Conn; Alexis Shub; Xavier Fagan; Daryl Guest; Robert Charles Andrew Symons; Lyndell L Lim
Author Affiliations & Notes
  • Felicia Widyaputri
    Ophthalmology, Department Surgery, University of Melbourne, East Melbourne, Victoria, Australia
    Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  • Mali Okada
    Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  • Sophie Rogers
    Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  • Alison Nankervis
    Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
    Diabetes and Endocrine Service, Royal Women’s Hospital, Melbourne, Victoria, Australia
  • Jennifer Conn
    Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
    Diabetes and Endocrine Service, Royal Women’s Hospital, Melbourne, Victoria, Australia
  • Alexis Shub
    Department of Obstetrics and Gynaecology, Mercy Hospital for Women, Melbourne, Victoria, Australia
  • Xavier Fagan
    Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
    Department of Ophthalmology, Austin Hospital, Melbourne, Victoria, Australia
  • Daryl Guest
    Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia
  • Robert Charles Andrew Symons
    Department of Ophthalmology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
    Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia
  • Lyndell L Lim
    Ophthalmology, Department Surgery, University of Melbourne, East Melbourne, Victoria, Australia
    Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  • Footnotes
    Commercial Relationships   Felicia Widyaputri, None; Mali Okada, Allergen (R); Sophie Rogers, None; Alison Nankervis, None; Jennifer Conn, None; Alexis Shub, None; Xavier Fagan, None; Daryl Guest, None; Robert Symons, Bayer (F), Novartis (F); Lyndell Lim, Abbvie (F), Allergan (F), Bayer (F), Novartis (R)
  • Footnotes
    Support  Alfred Felton Bequest; Department of Ophthalmology, Royal Melbourne Hospital; University of Melbourne Eyecare
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 4777. doi:
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      Felicia Widyaputri, Mali Okada, Sophie Rogers, Alison Nankervis, Jennifer Conn, Alexis Shub, Xavier Fagan, Daryl Guest, Robert Charles Andrew Symons, Lyndell L Lim; Diabetic Retinopathy in Pregnant Women with Type I and II Diabetes in Metropolitan Melbourne – Prevalence, Adherence and Barriers to the Recommended Eye Screening Guidelines. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4777.

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Abstract

Purpose : Diabetic Retinopathy (DR) can worsen during pregnancy; guidelines recommend at least one eye-check during pregnancy, ideally 3-monthly, to prevent vision loss. We report the prevalence of DR and sight-threatening DR in pregnant women with pre-existing diabetes and examine their adherence rates to the recommended screening guidelines.

Methods : Pregnant women with type 1 (T1DM) or type 2 diabetes were prospectively recruited from the Royal Women’s Hospital and Mercy Hospital for Women in Melbourne, Australia, from January 2018 to August 2018. Comprehensive eye examinations were provided without cost, and DR severity was graded from two-field retinal photographs. Barriers to attending eye screening were assessed with a modified Compliance with Annual Diabetic Eye Exams Survey.

Results : From 110 patients attending the Diabetes Pregnancy Clinic, 82 (74.5%) participated in this study. The mean age of participants was 33.65 years (range 19-47 years), with a median duration of diabetes of 7.3 years (range 0-29 years), and 32 (39%) had T1DM. Overall, DR was present in 20 (24.39%) women; 6 had sight-threatening disease (5 with diabetic macular oedema, 1 with proliferative DR). A retinal assessment was undertaken at least once during pregnancy in 66 (80.5%) women and 25 (30.5%) had the ideal number of examinations. Cost (p=0.02) and competing priorities (p=0.01) were the main reasons given for non-attendance.

Conclusions : Despite the risk of losing vision from worsening DR during pregnancy, only one-third of participants adhered to recommended screening guidelines, suggesting that eye examinations cost too much and eye health is not a priority in these patients. More proactive efforts to integrate care are needed to prevent visual loss in this growing demographic.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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Copyright © 2025 Association for Research in Vision and Ophthalmology.
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