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November 2, 2003

Complications, Family Planning

Question from West Chester, Pennsylvania, USA:

I'm 28 years old, and I have had proliferative diabetic retinopathy for three years. I had a vitrectomy in left eye and lots of laser surgery, resulting in scar tissue in both my eyes, and my vision is 2080. My husband and I decided not to have baby if I'm going to lose any more vision. Now I need to make a decision as to whether or not to have a baby. If I get pregnant, how is it going to affect my vision? Please help me to decide whether to have a baby myself or to look for other options.

Answer:

The fact that you have significant retinal disease is not good. Not only is your vision at risk, but you may also have vascular disease affecting other organs such as your kidneys. With these complications of diabetes, pregnancy is more risky in terms of poor fetal growth, pre-term delivery and increased risk of maternal complications such as preeclampsia.

From the literature I have read, it appears that advanced retinal disease is more likely to progress during pregnancy. So you are definitely taking a chance on your vision. I would recommend thinking very carefully about attempting a pregnancy and consulting with an ophthalmologist and a high-risk pregnancy specialist prior to trying.

OWJ
Additional comments from Dr. Charles Garcia:

I would suggest that you discuss these concerns with your retinal specialist. It is true that if one has diabetic retinopathy and becomes pregnant that there is an increased risk of progression of the retinopathy. In your situation you are at the “end stage” of retinopathy and have already been, I’m assuming, fully treated by laser photocoagulation. In this scenario I do not believe that any progression is likely from a pregnancy. I am not a retinal specialist and would be more comfortable if you expressed your concerns to one and I hope I have not given you false hope.

CAG