title: Acceleration of diabetic retinopathy in pregnancy: a case report.
abstract: OBJECTIVE
  Diabetic retinopathy can deteriorate during pregnancy. This usually manifests itself as an increase in the number of background retinopathy lesions, notably the appearance of new cotton wool spots, predominantly during the first trimester. The changes are usually attributed to the rapid attainment of tight glycaemic control during pregnancy. We present a case report of catastrophic deterioration in retinopathy during a period of stable glycaemic control.
  
  
  RESULTS
  J.P. had normal fundoscopic appearance at booking and during the early part of pregnancy. She experienced rapid deterioration in visual acuity secondary to cystoid macular oedema and vitreous haemorrhage during the third trimester of pregnancy. Her glycaemic control was stable at that stage and had not changed when compared with earlier stages of pregnancy. She required three sessions of intrapartum laser therapy and postpartum vitrectomy.
  
  
  CONCLUSIONS
  The case highlights the importance of regular retinal surveillance in a diabetic pregnancy, even in the absence of sudden improvements in glycaemic control.
authors.affiliation: Department of Diabetes, Endocrinology and Internal Medicine, Guy's, King's and St. Thomas' School of Medicine, King's College, London, UK.
authors.forename: S E
authors.initials: SE
authors.lastname: Joseph
authors.forename: D
authors.initials: D
authors.lastname: McHugh
authors.forename: M
authors.initials: M
authors.lastname: Blott
authors.forename: S A
authors.initials: SA
authors.lastname: Amiel
authors.forename: P J
authors.initials: PJ
authors.lastname: Watkins
mesh_terms: D000328:Adult; D017668:Age of Onset; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D053685:Laser Therapy; D049590:Postpartum Period; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000503:physiopathology*; D014821:Vitrectomy