Acceleration of diabetic retinopathy in pregnancy: a case report

Aims Diabetic retinopathy can deteriorate during pregnancy. This usually ma nifests itself as an increase in the number of background retinopathy lesio ns, notably the appearance of new cotton wool spots, predominantly during t he first trimester. The changes are usually attributed to the rapid attainm ent of tight glycaemic control during pregnancy. We present a case report o f catastrophic deterioration in retinopathy during a period of stable glyca emic control. Results J.P. had normal fundoscopic appearance at booking and during the ea rly part of pregnancy. She experienced rapid deterioration in visual acuity secondary to cystoid macular oedema and vitreous haemorrhage during the th ird trimester of pregnancy. Her glycaemic control was stable at that stage and had not changed when compared with earlier stages of pregnancy. She req uired three sessions of intrapartum laser therapy and postpartum vitrectomy . Conclusions The case highlights the importance of regular retinal surveilla nce in a diabetic pregnancy, even in the absence of sudden improvements in glycaemic control.