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

作　　者：Priscilla Peixi Choo Norshamsiah Md Din Nooraniah Azmi Mae-Lynn Catherine Bastion 

机构地区：[1]Department of Ophthalmology,Universiti Kebangsaan Malaysia Medical Centre,Kuala Lumpur 56000,Wilayah Persekutuan,Malaysia [2]Department of Ophthalmology,Universiti Putra Malaysia,Serdang 43400,Selangor,Malaysia

出　　处：《World Journal of Diabetes》2021年第9期1386-1400,共15页世界糖尿病杂志（英文版）（电子版）

基　　金：National University of Malaysia,Bangi,Selangor,Malaysia for English Editing,No.GP-K009894(2015).

摘　　要：Diabetes mellitus(DM)is a noncommunicable disease reaching epidemic proportions around the world.It affects younger individuals,including women of childbearing age.Diabetes 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)develops.Pregnancy is an independent risk factor for the progression of DR.Baseline DR at the onset of pregnancy is an important indicator of progression,with up to 10% of women with baseline NPDR progressing to PDR.Progression to sight-threatening DR(STDR)during pregnancy causes distress to the patient and often necessitates ocular treatment,which may have a systemic effect.Management includes prepregnancy counselling and,when possible,conventional treatment prior to pregnancy.During 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 STDR.Conventional treatment with anti-vascular endothelial growth factor agents for STDME can potentially lead to foetal loss.Treatment with laser photocoagulation may be preferred,and surgery under general anaesthesia should be avoided.This 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 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]