What are the ocular manifestations of gestational diabetes mellitus (GDM)?

Updated: Apr 29, 2020
  • Author: Thomas R Moore, MD; Chief Editor: George T Griffing, MD  more...
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Answer

Answer

Diabetic retinopathy is the leading cause of blindness in women aged 24-64 years. Some form of retinopathy is present in virtually 100% of women who have had type 1 diabetes for 25 years or more; of these women, approximately 1 in 5 is legally blind. [21] A prospective study showed that although half the patients with preexisting retinopathy experienced deterioration during pregnancy, all the patients had partial regression following delivery and returned to their prepregnant state by 6 months postpartum.

Other studies have suggested that rapid induction of glycemic control in early pregnancy stimulates retinal vascular proliferation. [22] However, when the total effect of pregnancy on ophthalmologic status was considered, progression of retinopathy was slower in pregnant than in nonpregnant women, probably because the modest deterioration in retinal status during rapid improvement in control is offset by the excellent control during the remainder of the pregnancy.

Consider an ophthalmologic evaluation in the first trimester.


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