[Diabetic retinopathy and pregnancy].

The problem concerning the influence of pregnancy on diabetic retinopathy is still a matter for discussion. The questions are: can the pregnancy itself influence the onset of a retinopathy? and can a pregnancy worsen the prognosis of a retinopathy and if it is the case is there any difference regarding the type of the retinopathy: background or proliferative? Despite controversies in the literature, it seems that: If no retinopathy is present at the onset of the pregnancy, the risk for developing retinal complications is very low. A background retinopathy can worsens and may become proliferative. But improvement is often observed in post-partum. A proliferative retinopathy worsen very frequently and the proper management of patients with this type of retinopathy is of extreme importance regarding to the risk of complications and loss of vision. Before the advent of photocoagulation, the alternative to therapeutic abortion was pituitary ablation. Now, the photocoagulation became the treatment of choice for proliferative retinopathy with the same results in pregnant or non pregnant woman. But the proliferative retinopathy is associated with a high incidence of foetal morbidity. Some studies provide evidence that changes in background retinopathy may be related to the degree of diabetic control achieved during pregnancy. The rapidity of improvement in diabetic control may be critical. Diabetic women who are wishing pregnancies may undergo ocular examination with angiography. During pregnancy strict ocular examination is necessary through dilated pupils. Angiography does not seem to induce any side effect on pregnant women.