title: Topographic change in the central macula coupled with contrast sensitivity loss in diabetic pregnancy.
abstract: OBJECTIVE
  To study macular topography and contrast sensitivity (CS) in diabetic and nondiabetic women during pregnancy and post partum.
  
  
  METHODS
  A prospective study of 46 pregnant women with insulin-dependent diabetes and 11 nondiabetic pregnant controls. Macular surface topography was analyzed by Heidelberg Retinal Tomograph. Volume above the reference plane (VARP) was measured with 1.0-, 1.5-, 2.0-, and 3.0-mm-diameter circles. CS was measured with the Vistech 6500 Contrast Test System.
  
  
  RESULTS
  The diabetic women had greater VARP than the controls measured with the 1.5-mm diameter circle. In diabetic women, the mean VARP was 0.084+/-0.064 mm(3) (mean +/- SD) in the first trimester, 0.080 +/- 0.056 mm(3) in the third trimester, and 0.087 +/- 0.067 mm(3) 3 months post partum compared with the values of 0.069+/-0.043, 0.054+/-0.024, and 0.036+/-0.020 mm(3) in the controls ( P=0.036 between groups). In diabetic women requiring laser treatment, the difference from controls was more significant ( P<0.001). CS at 3 cpd and 6.0 cpd was lower in diabetic women than in controls throughout pregnancy and post partum ( P=0.012 and P=0.043). A statistically significant negative correlation appeared between macular topography and CS during the third trimester; between cpd 6 and VARP 1.5 mm ( r=-0.471, P=0.001), and between cpd 6 and VARP 2.0 mm ( r=-0.446, P=0.002).
  
  
  CONCLUSIONS
  In the diabetic women, especially in those with clear progression of retinopathy during pregnancy and post-partum, the macula seemed to be slightly more elevated than in the controls, and CS was lower at mid-range spatial frequencies. CS loss in the diabetic women correlated with macular elevation during the third trimester.
authors.affiliation: Department of Ophthalmology, Helsinki University Central Hospital, Haartmaninkatu 4 C, PO Box 220, 00029 HUCH, Helsinki, Finland. sirpa.loukovaara@hus.fi
authors.forename: Sirpa
authors.initials: S
authors.lastname: Loukovaara
authors.forename: Mika
authors.initials: M
authors.lastname: Harju
authors.forename: Risto J
authors.initials: RJ
authors.lastname: Kaaja
authors.forename: Ilkka J R
authors.initials: IJ
authors.lastname: Immonen
mesh_terms: D016022:Case-Control Studies; D015350:Contrast Sensitivity; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D049590:Postpartum Period; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011263:Pregnancy Trimester, Third; D011254:Pregnancy in Diabetics / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology*; D011446:Prospective Studies