Download Central Corneal Thickness in Pregnancy: Longitudinal Study of

Central Corneal Thickness in
Pregnancy: Longitudinal Study of
Normal Pregnancies and Patients
With Gestational or Preexisting
Diabetes
Mohammadreza Peyman (MD), Florence Santiego (MMedOphth), Visvaraja
Subrayan (FRCOphth), Nurliza Khaliddin (MMedOphth)
University Malaya
[email protected]
http://www.drpeyman.net
The authors have no financial interest to disclose
Introduction
Pregnancy is a state of constant
paradigm shift involving the entire body of
a woman. The ocular structures are not
spared from these changes. Many studies
have already been done in relation to
changes that occurs to the cornea in
normal pregnancy. This study investigate
deeper and looks into the CCT in a normal
pregnancy (patient that has no DM),
pregnancy with underlying DM and GDM.
The purpose of this study is to find
changes in the central corneal
thickness (CCT) in the third trimester
and postpartum phase of normal
pregnancy, pregnant patients with
pre-existing diabetes mellitus (DM) or
gestational diabetic mellitus (GDM).
Methods:
 Patients who fulfilled the inclusion criteria were
recruited from the ophthalmology and obstetric
clinic University Malaya Medical Centre from June
2012 till January 2014 and were grouped according
to their co-morbidities (normal pregnancy,
pregnancy with pre-existing diabetes (DM) and
gestational diabetes mellitus (GDM). Ophthalmic
assessment and haemat8estigations were done in
the third trimester (after 30 weeks of gestation) and
postpartum phase (6 weeks post delivery). A total of
70 (36.5%) normal pregnancy patients, 51 (26.6%)
DM patients and 71 (36.9%) GDM patients were
included in this prospective study.
Result:
 Overall CCT was decreased post-delivery in studied
groups. Patients with GDM and pregnancy with
underlying diabetes did not have significantly increased
CCT in comparison with normal pregnant patients.
However, patients who had thicker CCT in the third
trimester, had thicker CCT post
delivery (p<0.001)
irrespective of which group they were in. However these
changes noted in the cornea did not appear to affect
the refractive error nor the visual acuity. Patients with
GDM and DM did not have significantly increased CCT
in comparison to normal pregnancy. Serum estrogen,
progesterone and HbA1c did not significantly affect the
Box plots above shows the distribution of estrogen in the third
trimester and postpartum phase.
Box plots above shows the distribution of progesterone in the
third trimester and postpartum phase.
Scatter plot above shows the distribution pattern of the
correlation between CCT in the third trimester and postpartum
phase of the left eye in each of the 3 groups
Conclusion:
 Lack of significant difference in CCT of patients with
normal pregnancy, pre-existing diabetes and GDM
highliths the physiological role of pregnancy on the
central corneal thickness rather than effect of diabetes.
CCT decreased by the same amount post delivery
irrespective of patient’s diabetes status. in this study
serum estrogen and progesterone did not significantly
affect central corneal thickness in pregnancy that
probably shows multifactorial cause of corneal change
in this group of patients.