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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.