THE EFFECT OF PREGNANCY ON MILD DIABETIC-RETINOPATHY

Purpose: To study microaneurysm (MA) formation and disappearance rates during pregnancy and postpartum in diabetic women with mild diabetic retinopathy. Methods: Red-free photographs were taken at the 12th, 24t h and 32nd-36th weeks of pregnancy and 3 and 6 months postpartum from 21 type 1 diabetics with mild diabetic retinopathy. In a subset of 13 patients follow-up was continued until 1 year after pregnancy. Fundus photographs were analysed using a computer-assisted fundus lesion loca lization system. Results: In the whole material the total MA count was 3.1 +/- 3.6 (mean +/- SD) at the 12th week, 3.4 +/- 3.1 at the 24th w eek, 4.1 +/- 4.9 ar the 32nd-36th week, 5.4 +/- 6.2 at 3 months postpa rtum and 5.2 +/- 5.8 at 6 months postpartum. We found that MA count in creased during pregnancy, but it was highest 3 months postpartum Both the rate of MA formation and the rate of MA disappearance increased du ring pregnancy, with the disappearance rate exceeding the formation ra te 6 months postpartum In patients having mean HbA1c levels below the median value of 6.38 mmol/l there was a flare-up of MAs during pregnan cy, levelling by 3 months postpartum. Patients with a higher than the median (0.76 mmol/l) decrease in HbA1c level compared to pre-pregnancy HbA1c also developed more MAs during thp course of pregnancy. Conclus ions: These data suggest that there is continuous turnover of MAs duri ng pregnancy. MA count increases during pregnancy but the MA count was highest 3 months postpartum, after which the formation rate started t o decline. Temporary aggravation of mild retinopathy occurs in diabeti c patients after normalization of blood glucose levels.