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Review of the management of sight-threatening diabetic retinopathy during pregnancy

World Journal of Diabetes 2021年第9期12卷 1386-1400页

作者： Priscilla Peixi Choo Norshamsiah Md Din Nooraniah Azmi Mae-Lynn Catherine Bastion Department of Ophthalmology Universiti Kebangsaan Malaysia Medical CentreKuala Lumpur 56000Wilayah PersekutuanMalaysia Department of Ophthalmology Universiti Putra MalaysiaSerdang 43400SelangorMalaysia

Diabetes mellitus(DM)is a noncommunicable disease reaching epidemic proportions around the *** affects younger individuals,including women of childbearing *** can cause diabetic retinopathy(DR),which is potentially sight threatening when severe nonproliferative DR(NPDR),proliferative DR(PDR),or sight-threatening diabetic macular oedema(STDME)*** is an independent risk factor for the progression of *** DR at the onset of pregnancy is an important indicator of progression,with up to 10% of women with baseline NPDR progressing to *** to sight-threatening DR(STDR)during pregnancy causes distress to the patient and often necessitates ocular treatment,which may have a systemic *** includes prepregnancy counselling and,when possible,conventional treatment prior to *** pregnancy,closer follow-up is required for those with a long duration of DM,poor baseline control of blood sugar and blood pressure,and worse DR,as these are risk factors for progression to *** treatment with anti-vascular endothelial growth factor agents for STDME can potentially lead to foetal *** with laser photocoagulation may be preferred,and surgery under general anaesthesia should be *** review provides a management plan for STDR from the perspective of practising ophthalmologists.A review of strategies for maintaining the eyesight of diabetic women with STDR with emphasis on prepregnancy counselling and planning,monitoring and safe treatment during pregnancy,and management of complications is presented.

关键词： Sight-threatening diabetic retinopathy Severe nonproliferative diabetic retinopathy Proliferative diabetic retinopathy Diabetic macula oedema Pregnancy Panretinal photocoagulation

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