Retinal outcomes in proliferative diabetic retinopathy presenting during and after pregnancy.

BACKGROUND The aim of this study was to determine retinal outcomes in patients with proliferative diabetic retinopathy (PDR) presenting during pregnancy or within the first year postpartum. METHODS All patients with diabetes mellitus during pregnancy from 1992 through 2002 were included. Medical records were reviewed and data including obstetric history, pregnancy outcome, other medical complications, and course and management of retinal disease were analyzed. RESULTS The study group comprised 6 women with a total of 7 pregnancies complicated by PDR during pregnancy or during the first year postpartum. Two of these pregnancies were in patients who had long-standing PDR and had received panretinal photocoagulation prior to pregnancy. Both of them had stable retinas during pregnancy and during the postpartum period. Three patients (4 eyes) who presented with high risk PDR during pregnancy required either repeated laser therapy (3 eyes) or vitrectomy (one eye) during the first year postpartum. Two patients (3 eyes) who did not have PDR at delivery developed PDR during the first year postpartum. After the second year postpartum, nine eyes which had developed PDR during or post pregnancy had stable retinas, two had developed phthisis, and one manifested end stage PDR. CONCLUSIONS Because of the persistent adverse effects of pregnancy on the retinas of women with diabetes mellitus, meticulous retinal surveillance and appropriate therapy are important not only during pregnancy but also during the postnatal period.