Evaluation of diabetic retinopathy during pregnancy by green monochromatic fundus photography

Abstract

iabetic retinopathy (DR) is the leading cause D of new blindness in people aged 20-64 years in Western society.’ The childbearing years correspond to the first half of this period. There is growing evidence that there is an increased risk of development and progression of DR during pregnancy. Contributing factors include the increase in retinal blood flow,’ cardiac output, levels of clotting factors and systemic coagulability, as well as the production of placental hormones such as placental lactogen, renin, and angiotensin.3 Green monochromatic fundus photography with a wavelength of 540-570 nm very accurately demonstrates hemoglobin-containing lesions in the internal retinal layers owing to the absorption of these wavelengths by hemoglobin (Figure 1). This relatively simple and noninvasive technique has been shown by Y assur et a1.4 to be superior to color fundus photography in detecting early hemoglobin (Hb)-containing changes in DR. Moreover, any lesion that was demonstrated by fluorescein angiography (FA) was also well observed by this technique. 4,5 Although no adverse effects of FA have been demonstrated during pregnancy, be-