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Background: In the modern world, diabetes mellitus is a disease that is growing in epidemic proportions. Numbers of women of childbearing age with this disease are also increasing. 

Aim: To develop a dose-defining algorithm for laser photocoagulation treatment of diabetic retinopathy and diabetic macular edema in pregnant women ensuring optimal efficacy and sustained effects. 

Materials and methods: 12 pregnant women with type I diabetes decompensation before and during pregnancy (НbА1с > 8 %, group 1), 10 women with compensated type I diabetes before and during pregnancy (НbА1с 4.5–6%, group 2), 10 women with type I diabetes decompensation before pregnancy and compensation of diabetesachieved during the 1st  trimester (НbА1c  6.5%, group 3) were enrolled. In all patients, routine  ophthalmological examination and optical coherent tomography were performed. 

Results: 39 eyes were treated with laser photocoagulation of the retina including 3 panretinal,  16 focal and 20 grid laser procedures. In the group 1, stabilization of the funduscopic picture was observed during the 3 trimester and in the longtermafter the laser treatment. During the 3rd  trimester, additional laser procedure was required in 4 eyes (16%) in the group 1 and in 2 eyes (10%) in the group 2.

Conclusion: Laser photocoagulation results in significant improvement of visual acuity. Visual function changes are dependent from diabetes compensation status, presence of macular edema and volume of the procedure.

About the authors

E. N. Khomyakova

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.
Email: veritas.elena@gmail.com

PhD, Research Associate, Ophthalmology Department

Russian Federation

S. G. Sergushev

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru
MD, PhD, Leading Research Associate, Ophthalmology Department Russian Federation

A. A. Ryabtseva

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru
MD, PhD, Professor, the Head of the Ophthalmology Department Russian Federation


  1. Дедов ИИ, Шестакова МВ, ред. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. 6-й выпуск. М.: Информполиграф; 2013. 103 с. (Dedov II, Shestakova MV. Algorithms of the specialized medical aid for diabetes mellitus patients. 6 edition. Moscow: Informpoligraf; 2013. 103 p. Russian).th
  2. American Diabetes Association. Standards of medical care in diabetes–2009. Diabetes Care. 2009;32 Suppl 1:S13–61.
  3. Экгардт ВФ. Диабетическая ретинопатия. Патогенез, клиника и лечение. Челябинск: Книга; 2001. 100 с. (Ekgardt VF. Diabetic retinopathy. Pathogenesis, clinical features and treatment. Chelyabinsk: Kniga; 2001. 100 p. Russian).
  4. Porta M, Kohner E. Screening for diabetic retinopathy in Europe. Diabet Med.
  5. ;8(3):197–8.
  6. Laursen ML, Moeller F, Sander B, Sjoelie AK. Subthreshold micropulse diode laser treatment in diabetic macular oedema. Br J Ophthalmol. 2004;88(9):1173–9.
  7. Астахов ЮС, Шадричев ФЕ, Лисочкина ЛБ. Диабетическая ретинопатия (тактика ведения пациентов). Клиническая офтальмология. 2004;5(2):85–8. (Astakhov YuS, Shadrichev FE, Lisochkina LB. [Diabetic retinopathy (conducting
  8. tactic)]. Klinicheskaya oftal'mologiya. 2004;5(2):85–8. Russian).
  9. Rotsos TG, Moschos MM. Cystoid macular edema. Clin Ophthalmol. 2008;2(4):919–30.
  10. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Early Treatment Diabetic Retinopathy Study research group. Arch Ophthalmol. 1985;103(12):1796–806.
  11. Klein BE, Moss SE, Klein R. Effect of pregnancy on progression of diabetic retinopathy. Diabetes Care. 1990;13(1):34–40.
  12. Aiello LP, Avery RL, Arrigg PG, Keyt BA, Jampel HD, Shah ST, Pasquale LR, Thieme H, Iwamoto MA, Park JE, et al. Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med. 1994;331(22):1480–7.
  13. Massin P, Bandello F, Garweg JG, Hansen LL, Harding SP, Larsen M, Mitchell P, Sharp D, Wolf-Schnurrbusch UE, Gekkieva M, Weichselberger A, Wolf S. Safety and efficacy of ranibizumab in diabetic macular edema (RESOLVE Study): a 12-month, randomized, controlled, double-masked, multicenter phase II study. Diabetes Care. 2010;33(11):2399–405.
  14. Mitchell P, Bandello F, Schmidt-Erfurth U, Lang GE, Massin P, Schlingemann RO, Sutter F, Simader C, Burian G, Gerstner O, Weichselberger A; RESTORE study group. The RESTORE study: ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular edema. Ophthalmology. 2011;118(4):615–25.

Copyright (c) 2016 Khomyakova E.N., Sergushev S.G., Ryabtseva A.A.

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