Efficacy of laser photocoagulation in pregnant women with diabetes mellitus
Background: In the modern world, diabetes mellitus is a disease that is growing in epidemic proportions. Numbers of women of childbearing age with this disease are also increasing. Aim: To develop a dose-defining algorithm for laser photocoagulation treatment of diabetic retinopathy and diabetic macular edema in pregnant women ensuring optimal efficacy and sustained effects. Materials and methods: 12 pregnant women with type I diabetes decompensation before and during pregnancy (НbА1с > 8%, group 1), 10 women with compensated type I diabetes before and during pregnancy (НbА1с 4.5-6%, group 2), 10 women with type I diabetes decompensation before pregnancy and compensation of diabetes achieved during the 1 st trimester (HbA1c 6.5%, group 3) were enrolled. In all patients, routine ophthalmological examination and optical coherent tomography were performed. Results: 39 eyes were treated with laser photocoagulation of the retina including 3 panretinal, 16 focal and 20 grid laser procedures. In the group 1, stabilization of the fundoscopic picture was observed during the 3 rd trimester and in the long-term after the laser treatment. During the 3 rd trimester, additional laser procedure was required in 4 eyes (16%) in the group 1 and in 2 eyes (10%) in the group 2. Conclusion: Laser photocoagulation results in significant improvement of visual acuity. Visual function changes are dependent from diabetes compensation status, presence of macular edema and volume of the procedure.