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S.C. Brauner, T.C. Chen, M.A. Chang, L.R. Pasquale, C.L. Grosskreutz; Glaucoma During Pregnancy . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5568.
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Purpose: Studies have shown that intraocular pressure decreases during pregnancy in normal women. Little data exist regarding the course of glaucoma during pregnancy in women with disease. We have compiled the largest case series to date of women with glaucoma during pregnancy. Methods: The charts of 14 women with glaucoma (32 eyes) who were followed by the authors during pregnancy were reviewed retrospectively. Some women had multiple pregnancies and each eye was treated as an independent event in the study. The data were analyzed with respect to age, race, type of glaucoma, medications, intraocular pressure, and visual fields before pregnancy, during each trimester, and postpartum. Results:The women in the study had various types of glaucoma, including juvenile (n=3 patients), aniridic (n=2), pigmentary (n=2), uveitic (n=2), angle closure (n=1), congenital (n=1), developmental (n=1), normal tension (n=1), and ocular hypertension (n=1). In 26 eyes intraocular pressure and visual field loss remained stable during pregnancy, despite a reduction in number of medications. Two eyes experienced an increase in intraocular pressure during pregnancy, with no progression of visual field loss. In 4 eyes, however, intraocular pressure was difficult to control and significant visual field loss was noted during pregnancy. The medications most frequently used during pregnancy included betablockers (n=13 patients), alpha–2 adrenergic agonists (n=6), topical carbonic anhydrase inhibitors (n=3), cholinergic agents (n=2), and prostaglandin analogs (n=2). There were no problems during pregnancy or in the offspring of the patients as a result of medication use. Conclusions: This is the largest case series to date of women with glaucoma who were followed during pregnancy. In some cases it is necessary to use glaucoma medications during pregnancy to control intraocular pressure and prevent further vision loss. The course of glaucoma is variable during pregnancy, and all women should be monitored closely for progression of disease.
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