Evaluation of Anterior and Posterior Segment Ophthalmological Findings in Gestational Diabetes Patients with OCT and OCTA in the Prepartum and Postpartum Periods

Project no. 23653 · Status: Kapanmış (Yayın bekleniyor) · 2022

Summary

Hormonal, metabolic and vascular changes that occur during pregnancy affect ocular physiology. During this process, many physiological or pathological changes may occur in the cornea and lens, such as refractive changes, retinal vascular changes, and progression of existing diabetic retinopathy findings. Gestational Diabetes Mellitus (GDM) is a disease characterized by hyperglycemia in the second and third trimesters of pregnancy and is an epidemic health problem with increasing prevalence.Diagnosisis determined by oral glucose tolerance test (OGTT) performed during 24-28th weeks of pregnancy. One-step 75 gram OGTT or two-step 50 gram and 100 gram OGTT can be used in diagnosis. This study was based on 75 gram OGTT results. Most of the time, no clinical signs of retinopathy are detected in GDM patients. Although fluorescein angiography is the standard method for imaging retinal vascular structures, its effects on the fetus are unknown. Optical Coherence Tomography Angiography (OCT-A) is a new technology that allows retinal and choroidal vascular structures to be examined noninvasively. There are studies in the literature reporting microvascular changes with OCT-A in pregnant women and GDM patients without clinical signs of retinopathy, but there are no studies on how these vascular changes progress in the postpartum period. In addition, it is known that both pregnancy and diabetes have effects on pachymetry, and there is limited data in the literature comparing the third trimester and postpartum central corneal thicknesses of GDM patients. Early detection of diabetic retinopathy and its precursor pathologies provides patients with early treatment when necessary. The aim of this study is to evaluate retinal microvascular changes, corneal topography and central corneal thickness and keratometry data of patients diagnosed with GDM on a 75-gram OGTT scan between May 2022 and December 2022 at the Ege University Faculty of Medicine. It was aimed to compare the patients with healthy pregnant women at the same gestational age. Additionally, it was aimed to compare the data of the patients and the healthy control group after the 6th week postpartum with the prepartum period.

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