Study Ocular Hemodynamics in Pregnant Women with Disorders of Carbohydrate Metabolism

Abstract

Purpose. To study state of ocular hemodynamics in pregnant women with disorders of carbohydrate metabolism using color Doppler imaging. Patients and methods. 147 pregnant women were examined: 40 of them had type 1 diabetes mellitus (DM), 87 had gestational diabetes (GD); in 20 — pregnancy proceeded physiologically. Examination of pregnant women with DM was carried out in each trimester and 3 months after delivery, pregnant women with GD and control groups — once in the third trimester. The parameters of hemodynamics in the central retinal artery (CRA) and in the short posterior ciliary arteries (SPCAs) were studied using color Doppler imaging. Results. It was found that the peak systolic velocity (PSV) in the CRA was significantly lower in the GD and DM groups, while PSV in the SPCAs and end-diastolic velocity (EDV) in the CRA were higher in the control group compared to the GD. In SPCAs, the resistive index (RI) was the highest in the DM group, and the lowest in the GD group. Conclusion. In patients with GD in the third trimester of pregnancy, there is a statistically significant decrease in PSV and EDV in the CRA and SPCAs, combined with a decrease in RI in SPCAs, compared with patients with a physiological course of pregnancy. In patients with diabetic retinopathy (DR) in the third trimester of pregnancy, PSV and EDV in the CRA and SPCAs were significantly lower, and the pulsatility index (PI) and RI were significantly higher compared to pregnant women with DM without DR. In pregnant women with DR during gestation, there was a decrease in PSV and EDV against the background of an increase in RI and PI in the CRA and in the SPCAs. In pregnant women with DM and absence of DR during gestation, there was an increase in PSV, EDV and PI in the CRA and SPCAs from the first to the third trimesters. The revealed features of the state of hemodynamics in the CRA and SPCAs in pregnant women with DM with presence or absence of DR can become the basis for creating criteria for manifestation and progression of DR.