Sinclair S H, Nesler C, Foxman B, Nichols C W, Gabbe S
Am J Ophthalmol. 1984 Feb;97(2):154-67. doi: 10.1016/s0002-9394(14)76085-4.
Seven women with insulin-dependent diabetes (mean age, 26 years; mean duration of diabetes, 15.4 years) had minimal or no retinopathy before becoming pregnant but developed severe macular edema associated with preproliferative or proliferative retinopathy during the course of their pregnancies. The edema was associated with significant macular capillary nonperfusion, and often with significant proteinuria and mild hypertension. Although proliferation was controlled with panretinal photocoagulation, the macular edema continued to worsen until delivery in all cases and was often aggravated by the photocoagulation. Macular edema and retinopathy both regressed after delivery in some patients but persisted in others, causing significant visual loss. Pregnant women with retinopathy, nephropathy, or hypertension should undergo ophthalmoscopy at least once a month. If proliferative retinopathy develops, panretinal photocoagulation should be applied even if the macular edema is aggravated.
七名胰岛素依赖型糖尿病女性（平均年龄26岁；平均糖尿病病程15.4年）在怀孕前视网膜病变轻微或无病变，但在孕期出现了与增殖前期或增殖性视网膜病变相关的严重黄斑水肿。水肿与黄斑部毛细血管显著无灌注有关，且常伴有大量蛋白尿和轻度高血压。尽管通过全视网膜光凝控制了增殖，但所有病例中的黄斑水肿在分娩前持续恶化，且光凝常使其加重。部分患者产后黄斑水肿和视网膜病变均消退，但其他患者则持续存在，导致严重视力丧失。患有视网膜病变、肾病或高血压的孕妇应至少每月接受一次眼底检查。如果发生增殖性视网膜病变，即使黄斑水肿加重也应进行全视网膜光凝。
