MACULAR BLOOD-FLOW DURING PREGNANCY IN PATIENTS WITH EARLY DIABETIC-RETINOPATHY MEASURED BY BLUE-FIELD ENTOPTIC SIMULATION

Purpose: To study macular capillary blood flow velocity during pregnan cy and postpartum in diabetic women with minimal diabetic retinopathy. Methods: Macular capillary blood velocity was measured using the blue -field entoptic simulation technique in 17 type I diabetic pregnant wo men with minimal background retinopathy and 10 healthy pregnant women at the 12th and 32nd-36th weeks of pregnancy and 3 months after delive ry Red-free fundus photography was also performed at all visits. Resul ts: Capillary blood velocities at the 12th week of pregnancy were 1.09 +/- 0.37 mm/s in the diabetic women and 0.81 +/- 0.21 mm/s in the con trols (P = 0.017), at the 32nd week 0.93 +/- 0.19 mm/s and 0.94 +/- 0. 24 mm/s (P = 0.880), and 3 months postpartum 0.98 +/- 0.25 mm/s and 0. 75 +/- 0.17 mm/s (P = 0.016), respectively. Analysis of variance indic ated that there was a significant difference in leukocyte velocities d uring the course of pregnancy, with the flow being constantly elevated in diabetic women, but increasing by term in nondiabetic women (P = 0 .039). Capillary flow velocity showed a statistically nonsignificant t endency to be higher in patients with HbA1c levels > 6.4%. Capillary f low velocity levels were not connected with changes in the number of m icroaneurysms. Capillary leukocyte density in the pregnant diabetic wo men did not differ from that of nondiabetic pregnant women. Conclusion s: These data suggest that during pregnancy there is a difference in r etinal capillary blood flow between diabetic women with minimal backgr ound retinopathy and normal women. The lack of increase in blood flow in macular capillaries during diabetic pregnancy may reflect redistrib ution of retinal capillary flow during diabetic pregnancy or be due to altered rheological properties of blood components in diabetic pregna ncy.