Assessment of retinal nonperfusion zones dynamics in pregnant women with diabetes mellitus according to optical coherence tomography — angiography

Purpose of the study was to investigate the possibility of assessing the dynamics of retinal non-perfusion zones in pregnant women with diabetes mellitus (DM) using a standard and the proposed objective method. Material and methods. Fifty-seven pregnant women (114 eyes) were examined: 28 with DM, including 17 with diabetic retinopathy (DR), and 29 without concomitant somatic pathology. Using optical coherence tomography angiography (OCTA), the total area of non-perfusion zones was assessed using the device software. In addition, an objective assessment of changes in the proportion of retinal non-perfusion zones was performed using the proposed method with a graphic editor. Results. Throughout pregnancy and 3 months after delivery, patients with DR progression showed a significant increase in the total area of non-perfusion zones. In the third trimester, the proportion of non-perfusion zones in both plexuses was higher in the DM group than in the control. An increase in the proportion of nonperfused zones in both plexuses and a dynamic increase in the total area of retinal nonperfused zones from the first trimester to the third trimester and at 3 months postpartum were found in the subgroup with progressive DR. Conclusion. OCTA allows for the assessment of changes in nonperfused retina in pregnant women with DM. This method of objectively assessing the dynamics of retinal nonperfusion zones enables quantitative assessment of changes in nonperfused retina areas separately for the superficial and deep retinal plexuses.