Effectiveness of retinal laser coagulation in treatment of diabetic retinopathy in pregnant women with diabetes mellitus

    Abstract

    Original article

    Effectiveness of retinal laser coagulation in treatment of diabetic retinopathy in pregnant women with diabetes mellitus

    N.V. Pomytkina, E.L. Sorokin, G.V. Chizhova

    S. Fyodorov Eye Microsurger y Federal State Institution, Khabarovsk branch, Khabarovsk, Russian Federation
Far-Eastern State Medical University, Khabarovsk, Russian Federation
Postgraduate Institute for Public Health Workers, Khabarovsk, Russian Federation

    Purpose. Evaluation of retinal laser coagulation (RLC) effectiveness in the treatment of diabetic retinopathy (DR) in pregnant women with diabetes mellitus (DM).

    Material and methods. A total of 69 pregnant women with type 1 diabetes and DR were examined. DR was detected in 28% of patients in the pregestational period and RLC was performed. DR manifested during gestation in 72% of women. Proliferative DR (PDR) was observed in 61% of patients, preproliferative DR (PPDR) in 23%, and nonproliferative DR in 16%. Diabetic macular edema in both eyes was detected in 12 patients. Stable DR during gestation was observed in 29% of pregnant women, and progressive DR was observed in 71%. The examination was conducted throughout pregnancy and after delivery.

    Results. 75% of pregnant women in the stable DR subgroup were patients who had undergone RLC before pregnancy. Pregnant women with progressive PDR and PPDR during gestation underwent panretinal laser coagulation (PRLC), and in cases of flat or focal macular edema — RLC in the macular area. In 78% of patients with DR progression, RLC during gestation allowed stabilizing the DR course before delivery. In 11 of 49 patients (22%), despite PRLC, DR progressed after delivery, but their visual functions remained high in the late period.

    Conclusion. In 75% of patients after pregestational RLC, a stable course of DR was observed throughout pregnancy. PRLC, performed during gestation in the case of progressive DR, allowed to stabilize its course in 78% of pregnant women. In the group of severe DR with ongoing progression after PRLC during gestation, laser treatment reduced the risk of developing severe complications of PDR.

    Key words: diabetic retinopathy, pregnancy, retinal laser coagulation

    For citation: Pomytkina N.V., Sorokin E.L., Chizhova G.V. Effectiveness of retinal laser coagulation in treatment of diabetic retinopathy in pregnant women with diabetes mellitus. Fyodorov Journal of Ophthalmic Surgery. 2025;3(146): 60–67.

    DOI: 10.25276/0235-4160-2025-3-60-67

    Corresponding author: Natal’ya V. Pomytkina, naukakhvmntk@mail.ru