Managing Glaucoma During Pregnancy

Higginbotham, Eve J.

doi:10.1001/jama.296.10.1284

Cited by 4 publications

(5 citation statements)

References 5 publications

(2 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is little literature demonstrating the teratogenic effects of the commonly prescribed anti-glaucoma medications and few studies have specifically examined the potential harms of the topically applied anti-glaucoma medications. [6][7][8][9]21 The US Food and Drug Administration (FDA) classifies drugs into several categories of safety levels for use during pregnancy. 1.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, most women with glaucoma may be treated efficiently during pregnancy. 7 Once medication is started, the patient should be monitored frequently. The clinician must be mindful of the possibility of adverse effects and be prepared to alter or terminate treatment if needed.…”

Section: Anti-glaucoma Medications In Pregnancy Razeghinejad and Nowrmentioning

confidence: 99%

“…4 Therefore, when antiglaucoma medications are prescribed for pregnant women, the clinicians must consider the potential systemic effects not only on the mother, but also on the developing foetus. [5][6][7][8][9] Unfortunately, there is little definitive information concerning the use of antiglaucoma medications in pregnant glaucomatous patients. Further speculative observation of patients who have used glaucoma medications during pregnancy seems necessary to help physicians prescribe appropriate anti-glaucoma medications during pregnancy.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Anti‐glaucoma medication exposure in pregnancy: an observational study and literature review

Razeghinejad

Nowroozzadeh

2010

Clinical and Experimental Optometry

View full text Add to dashboard Cite

Background: There are limited data about the effects of anti-glaucoma drugs on pregnancy. The purpose of this study was to observe pregnancies exposed to anti-glaucoma medications. Methods: Six pregnant glaucomatous patients referred to the glaucoma clinic after their first trimesters were advised to continue their medications. In one patient who was on oral acetazolamide, the drug was substituted with topical medications. In the last month of pregnancy acetazolamide was started and all topical medications were stopped. The control group comprised 24 individuals with no systemic disease or exposure to medications and with comparable age and gestational age on delivery. Pregnancy and delivery complications, Apgar scores at one and five minutes, birth weight, congenital anomalies and psychophysical development of children up to two years of age were evaluated. Results: The mean age of the patients was 28.17 years with mean gestational age on delivery of 38.80 weeks. Low birth weight was more common in the case group (p = 0.041). No other side-effects were observed. The one-minute Apgar scores were nine in all newborns and improved to 10 at five minutes. The psychophysical development of all children was normal up to two years after birth. Conclusions: Analysis of pregnancy outcome of six mothers taking topical glaucoma medications showed no adverse effects apart from a small but statistically significant increased risk of having low birth weight.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Anti-glaucoma Medications In Pregnancy Razeghinejad and Nowrmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Anti‐glaucoma medication exposure in pregnancy: an observational study and literature review

Razeghinejad

Nowroozzadeh

2010

Clinical and Experimental Optometry

View full text Add to dashboard Cite

show abstract

“…In low-risk glaucoma, treatment is generally avoided during pregnancy. However, in high-risk patients, medical and even surgical treatment should be offered [23,25,26]. A consensus statement from the World Glaucoma Association suggests reasonable initial targets are 35 mmHg for mild, 30 mmHg for moderate and 25 mmHg for advanced glaucoma in the first 20 weeks; and 30 mmHg for mild, 25 mmHg for moderate and 20 mmHg for advanced glaucoma from 20 weeks onwards [24].…”

Section: Glaucoma and Pregnancymentioning

confidence: 99%

Pregnancy and the eye

Khong

Chan

Watson

2021

Current Opinion in Ophthalmology

View full text Add to dashboard Cite

Purpose of reviewThe aim of this study was to summarize common eye changes that may occur during pregnancy, and how pregnancy may affect preexisting eye conditions such as glaucoma and diabetic retinopathy. Challenges and complexities surrounding the treatment of these eye conditions during pregnancy are also highlighted. Recent findingsRefractive changes are common and may persist in the postpartum in patients with keratoconus. Although new medical and surgical glaucoma treatments are available, their safety in pregnancy is unknown. Limited use of topical and systemic glaucoma therapies is recommended, with a preference for selective laser trabeculoplasty as first line treatment in appropriate cases. The impact of pregnancy on diabetic retinopathy remains unclear. Although anti-vascular endothelial growth factor agents are first-line treatment for sight-threatening diabetic retinopathy, their effect on the developing foetus remains unknown and are therefore best avoided in the first and second trimesters. Noninfectious uveitis tends to become less active during pregnancy, allowing the potential tapering of systemic therapy and the use of local topical or injected corticosteroid treatment for active disease as required.

show abstract

“…HLs should generally be avoided in women of child bearing age without adequate birth control or who are pregnant, because although plasma concentrations of topical HLs are low, there is a theoretical risk of abortion due to the action of prostaglandin molecules on uterine smooth muscle. [216][217][218] There are no references in the ophthalmic literature that this has ever happened (see Chap. 58 for discussion of glaucoma therapy during pregnancy.)…”

Section: Hypotensive Lipidsmentioning

confidence: 99%

Medications Used to Treat Glaucoma

Schacknow

Samples

2010

The Glaucoma Book

View full text Add to dashboard Cite

ConclusionOptimal therapy for glaucoma would involve IOP control throughout the 24-h period. However, not all therapies are equally efficacious at all times of the day and night. Understanding of the mechanisms of action of different therapies, along with the knowledge of the circadian changes in aqueous humor dynamics, allows us to predict the therapies that will provide the most consistent IOP reduction. As well, understanding of aqueous humor dynamics may help in the development of future therapies with consistent 24-h IOP control. Bibliography

show abstract

Managing Glaucoma During Pregnancy

Cited by 4 publications

References 5 publications

Anti‐glaucoma medication exposure in pregnancy: an observational study and literature review

Anti‐glaucoma medication exposure in pregnancy: an observational study and literature review

Pregnancy and the eye

Medications Used to Treat Glaucoma

Contact Info

Product

Resources

About