Managing Glaucoma During Pregnancy

Abstract

Stacey C. Brauner, MD; Teresa C. Chen, MD; B. Thomas Hutchinson, MD; Michael A. Chang, MD; Louis R. Pasquale, MD; Cynthia L. Grosskreutz, MD, PhDObjective: To better understand the course of glaucoma during pregnancy in women with preexisting disease.Methods: Retrospective case series of 28 eyes of 15 women with glaucoma followed up during pregnancy. Data were analyzed for age, race/ethnicity, medications, glaucoma type, intraocular pressure (IOP), and visual fields before, during, and after pregnancy.Results: In 16 (57.1%) of 28 eyes, IOP was stable during pregnancy, with no progression of visual field loss. In 5 eyes (17.9%), visual field loss progressed during pregnancy, while IOP remained stable or increased. In 5 eyes (17.9%), IOP increased during pregnancy, but there was no progression of visual field loss. In 2 eyes (7.1%), data were inconclusive because of medication noncompliance and preexisting severe visual field loss. Glaucoma medications were used by 13 of 15 patients to control glaucoma during pregnancy. The classes of medications used most frequently were β-blockers, α2-adrenergic agents, cholinergic agents, and topical carbonic anhydrase inhibitors.Conclusions: The course of glaucoma during pregnancy is variable, and women must be monitored closely during pregnancy. Medications may be necessary to control IOP and to prevent vision loss during pregnancy.