Mendez-Hernandez Carmen, Garcia-Feijoo Julian, Saenz-Frances Federico, Santos-Bueso Enrique, Martinez-de-la-Casa Jose Maria, Megias Alicia Valverde, Fernández-Vidal Ana M, Garcia-Sanchez Julian
Ophthalmology Department, Hospital Clinico San Carlos de Madrid, Madrid, Spain.
Clin Ophthalmol. 2012;6:1629-32. doi: 10.2147/OPTH.S36712. Epub 2012 Oct 8.
To assess the course of intraocular pressure (IOP), visual field progression, and adverse effects of antiglaucoma medication used during pregnancy.
Thirteen eyes of eight patients with glaucoma were examined. Their clinical records were reviewed to compare IOP, number of medications, and visual field indices (VFI) before, during, and after pregnancy using a two-tailed paired t-test.
In seven (87.5%) of the eight patients, no disease progression was observed. IOP (mmHg) remained stable (baseline 17.3 ± 3.6; first trimester 17.4 ± 5.2, P = 0.930; second trimester 18.1 ± 4.7, P = 0.519; third trimester 20.2 ± 8.7, P = 0.344; and postpartum 21.5 ± 7.6, P = 0.136). The mean number of glaucoma treatments fell from 1.7 ± 0.52 before pregnancy to 0.83 ± 0.75 (P = 0.04) in the second and third trimesters. In one patient, IOP increased during pregnancy and there was further visual field loss. In the only patient kept on fixed combination timolol-dorzolamide therapy throughout pregnancy, labor was induced because of delayed intrauterine growth.
No changes in IOP and VFI were detected in most patients despite a reduction in the number of hypotensive agents required. Delayed intrauterine growth in one patient under fixed combination timolol-dorzolamide treatment was observed whereas no other adverse effects were detected.
评估妊娠期间眼压(IOP)的变化过程、视野进展情况以及抗青光眼药物的不良反应。
对8例青光眼患者的13只眼进行检查。回顾其临床记录,采用双尾配对t检验比较妊娠前、妊娠期间和妊娠后的眼压、用药数量和视野指数(VFI)。
8例患者中有7例(87.5%)未观察到疾病进展。眼压(mmHg)保持稳定(基线值17.3±3.6;孕早期17.4±5.2,P = 0.930;孕中期18.1±4.7,P = 0.519;孕晚期20.2±8.7,P = 0.344;产后21.5±7.6,P = 0.136)。青光眼治疗的平均用药数量从妊娠前的1.7±0.52降至孕中期和孕晚期的0.83±0.75(P = 0.04)。1例患者在妊娠期间眼压升高,视野进一步丧失。在整个妊娠期间一直使用噻吗洛尔 - 多佐胺固定复方制剂治疗的唯一1例患者中,因宫内生长迟缓而引产。
尽管所需降压药物数量减少,但大多数患者的眼压和视野指数未发现变化。观察到1例接受噻吗洛尔 - 多佐胺固定复方制剂治疗的患者出现宫内生长迟缓,未检测到其他不良反应。