Macular and Retinal Nerve Fibre Layer Thickness in Pregnant Women with Gestational Diabetes Mellitus

Ganglion cell complex and retinal nerve fiber layer thickness in gestational diabetes mellitus

PURPOSE

The purpose of this study was to compare ganglion cell complex and peripapillary retinal nerve fiber layer (RNFL) thickness between pregnant females with gestational diabetes mellitus (GDM) and healthy pregnant females.

MATERIALS AND METHODS

This was a single-center, prospective, analytical cross-sectional study including pregnant females with a gestational age of 24 weeks or more in the GDM and control groups. The GDM group included 162 pregnant females with GDM, and the control group included 162 healthy pregnant females. Peripapillary RNFL (pRNFL), macular RNFL (mRNFL), GCL+ (ganglion cell layer [GCL] + inner plexiform layer [IPL]), and GCL++ (mRNFL + GCL + IPL) thickness were analyzed using spectral-domain optical coherence tomography (OCT), and comparisons were made between the groups.

RESULTS

Both the groups had similar mean age (P = 0.219), intraocular pressure (P = 0.186), central corneal thickness (P = 0.689), Schirmer test value (P = 0.931), and tear breakup time (P = 0.651). The mean pRNFL thickness of the GDM and control groups was 100.75 ± 8.36 μm and 106.77 ± 8.44 μm (P < 0.0001). pRNFL was significantly thinner in all four quadrants (P < 0.05) in the GDM compared to the control group. We observed that the mean mRNFL, GCL+, and GCL++ thickness were significantly reduced in GDM in comparison to the control group (P < 0.05).

CONCLUSION

Our study showed that OCT plays an indispensable role in determining initial retinal changes caused by GDM before the development of diabetic retinopathy.

Gestational Diabetes Mellitus in Southeast Asia: A Scoping Review

A rapid increase in the prevalence of gestational diabetes mellitus (GDM) has been associated with various factors such as urbanization, lifestyle changes, adverse hyperglycemic intrauterine environment, and the resulting epigenetic changes. Despite this, the burden of GDM has not been well-assessed in Southeast Asia. We comprehensively reviewed published Southeast Asian studies to identify the current research trend in GDM in this region. Joanna Briggs Institute’s methodology was used to guide the scoping review. The synthesis of literature findings demonstrates almost comparable clinical evidence in terms of risk factors and complications, challenges presented in diagnosing GDM, and its disease management, given the similarities of the underlying population characteristics in Southeast Asia. Evidence suggests that a large proportion of GDM risk in women may be preventable by lifestyle modifications. However, the GDM burden across countries is expected to rise, given the heterogeneity in screening approaches and diagnostic criteria, mainly influenced by economic status. There is an urgent need for concerted efforts by government and nongovernmental sectors to implement national programs to prevent, manage, and monitor the disease.