Retinal nerve fiber layer thickness and macular ganglion cell analysis in gestational diabetes mellitus in various trimesters-A case series study.

Govindasamy, Jayalakshmi; Sridharan, Ilamathi; Mahendran, Rajalakshmi · J Family Med Prim Care · 2025

case_series · Level IV

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Abstract

Gestational diabetes mellitus (GDM) is a glucose intolerance state that is induced by pregnancy, and the condition may resolve or persist even after the pregnancy period. We documented four cases of GDM from different trimesters and puerperium. Optical coherence tomography (OCT) imaging in these cases revealed that the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL)+, and GCL++ layers were thinned, indicating neuronal degeneration in GDM. Our results imply that in GDM, retinal neurodegeneration occurs before developing diabetic retinopathy, not only in pregnancy but also in puerperium. It is mandatory to carry out the routine evaluation of retina with the help of OCT in all GDM patients to detect early neurodegenerative changes. By measuring these layers, clinicians can observe the progression of diabetic retinopathy and determine the benefit of treatment strategies.