Ziai N, Ory S J, Khan A R, Brubaker R F
Department of Ophthalmology, Mayo Clinic, Rochester, Minn.
Arch Ophthalmol. 1994 Jun;112(6):801-6. doi: 10.1001/archopht.1994.01090180099043.
To determine whether the altered hormonal milieu of pregnancy is associated with changes in the dynamics of aqueous humor formation and drainage.
Nineteen women were studied during each trimester of a single pregnancy and post partum. Measures of aqueous dynamics included intraocular pressure, aqueous flow, facility of outflow, aqueous flare, and corneal thickness.
Pregnancy was associated with relatively lower intraocular pressure, reduced aqueous flare, increased corneal thickness, and increased aqueous outflow facility. Aqueous flow was unchanged. The progesterone level increased during pregnancy and decreased during the postpartum period. The beta-human chorionic gonadotropin level was highest during the first trimester. The progesterone level, but not the beta-human chorionic gonadotropin level, was correlated with intraocular pressure, aqueous flare, and corneal thickness. The change in aqueous outflow facility that accompanied pregnancy could not be correlated directly to changes in beta-human chorionic gonadotropin or progesterone concentrations.
Aqueous flow remains constant during and after pregnancy, but intraocular pressure decreases during pregnancy due to an increase in the outflow facility. The changes in aqueous dynamics are consistent with the hypothesis that excess progesterone during pregnancy blocks the ocular hypertensive effect of endogenous corticosteroids. However, we were unable to find a statistically significant correlation when a direct comparison between the observed changes in outflow facility and the observed changes in the progesterone level was made, perhaps because of intersubject variability of these changes. The changes in intraocular pressure and outflow facility could have been due to one of many other changes in pregnancy that were not measured.
确定妊娠期间激素环境的改变是否与房水生成和引流动力学的变化有关。
对19名女性在单次妊娠的每个孕期及产后进行研究。房水动力学指标包括眼压、房水流量、流出易度、房水闪光和角膜厚度。
妊娠与相对较低的眼压、降低的房水闪光、增加的角膜厚度和增加的房水流出易度相关。房水流量未改变。孕酮水平在孕期升高，产后降低。β-人绒毛膜促性腺激素水平在孕早期最高。孕酮水平而非β-人绒毛膜促性腺激素水平与眼压、房水闪光和角膜厚度相关。妊娠时伴随的房水流出易度变化不能直接与β-人绒毛膜促性腺激素或孕酮浓度的变化相关联。
妊娠期间及产后房水流量保持恒定，但由于流出易度增加，孕期眼压降低。房水动力学的变化与妊娠期间过量孕酮阻断内源性皮质类固醇的眼压升高作用这一假说一致。然而，当对观察到的流出易度变化和孕酮水平变化进行直接比较时，我们未能发现统计学上的显著相关性，这可能是由于这些变化存在个体间差异。眼压和流出易度的变化可能是由于妊娠期间未测量的许多其他变化之一所致。
