1型糖尿病孕妇糖尿病视网膜病变进展的临床病例分析

N. Pomytkina
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摘要

本文介绍了 1 型糖尿病孕妇糖尿病视网膜病变(DR)进展的临床病例。在增殖前糖尿病视网膜病变中,两只眼睛都出现了黄斑区局灶性水肿,黄斑区周围出现非灌注区。两只眼睛都接受了视网膜激光凝固治疗。一个月后,左眼黄斑水肿消退,双眼出现出血现象,并出现了新的非灌注区。妊娠期和产后的 DR 进展由多种因素决定,包括糖尿病代偿、视网膜病变稳定以及并发症的存在。在增殖性 DR 的恶化过程中,左眼出现局部牵引性视网膜脱离和部分眼球下垂。在这个病例中,对双眼进行了三个阶段的全视网膜激光凝固术,并对左眼进行了硅酮填塞的玻璃体内介入治疗。妊娠 28 周时,观察到右眼视网膜新生血管进展,后极部出现大面积非灌注区。右眼视网膜的激光凝固区域被压缩。
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Аnalysis of clinical cases of diabetic retinopathy progression in pregnant women with type 1 diabetes
This paper presents clinical cases of diabetic retinopathy (DR) progression in pregnant women with type 1 diabetes. In preproliferative DR, the formation of focal macular edema in both eyes with nonperfusion areas of perimacular localization was observed. Both eyes were subjected to laser coagulation of the retina. After one month, a regression of macular edema in the left eye and hemorrhagic phenomena in both eyes was established with the emergence of new nonperfusion zones. DR progression during pregnancy and in the postpartum period is determined by a number of factors, including diabetes mellitus compensation, retinopathy stabilization, and the presence of concomitant pathologies. In the aggressive course of proliferative DR, local traction retinal detachment and partial hemophthalmos of the left eye were revealed. In this case, three stages of panretinal laser coagulation of both eyes and endovitreal intervention with silicone tamponade on the left eye were performed. At 28 weeks of gestation, progression of retinal neovascularization was observed in the right eye, extensive areas of nonperfusion in the posterior pole. The areas of laser coagulation of the retina were compacted in the right eye.
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