There is an increased risk of sight threatening diabetic retinopathy in pregnant women thought to be due to poor glycaemic control before pregnancy with tight glycaemic control in early pregnancy, other factors include hypertension, neuropathy and preecamplsia. The NICE guidelines state that all women with pre-existing diabetes should be offered DR screening at their first antenatal appointment and if normal then again at 28 weeks. If signs Diabetic Retinopathy and Maculopathy present additional appointments should be given at 16-20 weeks and immediate referrals to HES for severe cases.
As pregnant women are at higher risk of clinically significant macular oedema it is not known whether macula thickness changes in all diabetic women throughout their pregnancy. For the purpose of the audit pregnant patients also had a Stratus Optical Coherence Tomography scan at the time of their screening. The audit compares the macular volume and central foveal thickness of pregnant patients throughout their gestational period.
The aims of the audit are:
- To determine whether macular thickness changes throughout pregnancy.
- To determine whether all pregnant women should also have an OCT as well as retinal photography during their pregnancy.