Her antenatal care provider has switched her into insulin regime during this pregnancy and her blood sugar profile was within acceptable range till the current visit. Her serum glycosylated hemoglobin level (HbA1C) at her first antenatal visit was 8.5%. She had been having fluctuating glycemic control. She was on oral Glucovance (Glyburide and Metformin HCl) 5/500 mg BD till her pregnancy.
She initially presented with diabetic ketoacidosis which required intubation and intensive care unit admission for 2 weeks. She was diagnosed to have type 2 diabetes mellitus 2 years ago. No history flashes of lights, redness or ocular pain. She also was complaining of bilateral mild blurring of vision. She said the floaters started about 2 weeks prior to the visit and slowly improving over the time. Upon presentation on her first diabetic retinopathy screening, she was complaining of floaters in her both her eyes. However, patient did not attend any diabetic retinopathy screening until her 22nd week of gestation due to logistics problem. Madam G, a 31-year-old primigravida, with underlying type 2 diabetes mellitus was referred for diabetic retinopathy assessment by her antenatal care provider in her first trimester. This case report highlights a case of diabetic retinopathy in pregnancy which progressed rapidly and was successfully treated with timely surgical intervention and achieved good final visual outcome. The risk factors for the progression of retinopathy in pregnancy are severity of retinopathy at conception, adequacy of treatment, duration of diabetes, metabolic control before pregnancy, and the presence of additional vascular damage, such as nephropathy and hypertension. Currently, meticulous control of the glycemic levels during pregnancy has been shown to decrease in the incidence of fetal malformations and maternal complications. In the past, prognosis for pregnancy in diabetic women with microvascular changes was so poor that many physicians advised either avoidance or termination of pregnancy in high risk patients. Established sight-threatening retinopathy should be treated at an earlier stage in pregnant women compared to non-pregnant diabetics with a similar disease. Diabetic eye disease may develop for the first time during pregnancy, and visual impairment at this stage has serious implications for both the patient and her family. The adverse effects of pregnancy on retinal status persist into the first year postpartum. Women with pre-gestational diabetes are at risk of progression during the pregnancy. Retinopathy affects 20% to 27% of women with diabetes mellitus in the reproductive age group. Keywords: Diabetic retinopathy Pregestational diabetes Vitrectomy Advanced diabetic eye disease Introduction This case report highlights a case of diabetic retinopathy in pregnancy which progressed rapidly and was successfully treated with timely surgical intervention resulting in good final visual outcome. The doctor moves the ultrasound wand against the front surface of your eye.Women with pre-gestational diabetes are at risk of progression of diabetic retinopathy during the pregnancy. Then the doctor gently moves a small ultrasound wand against your eyelid.Įyes open: Eyedrops are used to numb your eyes. The doctor puts ultrasound gel on your eyelid. This test usually takes about 30 minutes.Įyes closed: You sit in a chair with your eyes closed.Photos are taken as the dye enters the eyes.It takes only a few seconds for the dye to be visible in the blood vessels in your eyes.
An IV needle is placed in a vein in your arm, and the dye is injected.Angiogramīefore an angiogram, a dye is injected into your vein.
It only takes a few minutes to take the pictures. You can breathe and blink normally while the camera photographs or scans your eyes. Keep your mouth closed, open your eyes as wide as you can, and stare straight ahead. And you'll brace your forehead against a bar to keep it still. You'll sit and wait for about half an hour for the drops to take effect.įor most tests, you'll sit in a chair facing the camera. Retinal imaging tests are done in a hospital or doctor's office.įor some tests, the doctor will first use eyedrops to widen, or dilate, your pupils.
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