PREVELENCE OF DIABETIC RETINOPATHY IN PREGESTATIONAL TYPE 2 DIABETES – AN OBSEVATIONAL STUDY

Abstract

AIMS: The aim of this observational study is to evaluate pattern and progression of diabetic retinopathy (DR) during pregnancy in females with pregestational type 2 diabetes mellitus (DM).

Method: This cross-sectional, population based study conducted at tertiary care centre, GMC Jammu on patients with pregestational DM. The study was done for 10 months from May 2017 to February. A total of 60 pregnant females with pregestational DM were included in study while those with gestational DM excluded from study. Ocular examination was done the fundus was examined with direct and indirect ophthalmoscopes, +90 D with slit lamp and fundal photography. Retinopathy was graded using the International Clinical Diabetic Retinopathy Disease Severity Scale (ICDRDSS). (Including fundus photography) and systemic assessment (including renal assessment and glycatedhaemoglobin) was done. DR was classified as: no apparent retinopathy (no DR), mild non-proliferative DR (mild NPDR), moderate NPDR, severe NPDR, proliferative DR (PDR) and diabetic macular oedema (DMO). Non-vision threatening DR (non-VTDR) included mild and moderate NPDR; VTDR included severe NPDR, PDR and DMO. Prevalence and progression of DR during pregnancy in the study cohort were the main outcome measures.

Results: Out of 60 patients of type 2 DM. On screening, 7 cases had nonproliferative DR (NPDR), and 1 had proliferative DR (PDR). During the study period, worsening observed in patient having PDR. Change in visual acuity observed in PDR patients but not in NPDR.  No patient with NPDR converted to PDR. No new onset DR in the patients without DR at presentation. Assessment of risk factors for DR revealed significantly higher duration of DM.

Conclusion:  No conversion from NPDR to PDR was observed. No new case of DRwas observed. Worsening of PDR case was observed. If any associated risk factor is present, careful monitoring during pregnancy required.

Keywords: Diabetes mellitus, pregnancy, diabetic retinopathy, pregestational diabetes