glaucoma medical therapies

青光眼药物治疗
  • 文章类型: Journal Article
    目的:妊娠期青光眼的治疗对眼科医生来说是一项具有挑战性的任务。由于伦理问题,研究有限,确切的管理协议尚未建立。由于对胎儿器官发生的有害影响和麻醉的有害影响,手术已被提及为妊娠中期的一种选择,并且在妊娠中期避免了手术。
    方法:一名26岁的晚期青光眼患者在妊娠早期接受了小梁切除术,没有使用抗纤维化药物。
    结果:妊娠期间眼压(IOP)得到良好控制,不需要额外的抗青光眼药物。她足月分娩了一个健康的婴儿,没有先天性异常。
    结论:没有抗纤维化药物的小梁切除术可以在妊娠的前三个月进行,如果使用局部抗青光眼药物不能控制眼压,在这个时期被认为是安全的。这是有关妊娠早期小梁切除术的文献中的第一份报告。
    OBJECTIVE: Glaucoma management in pregnancy is a challenging task for the ophthalmologist. With limited studies due to ethical concerns, the exact management protocols are not well established. Surgery has been mentioned as an option in 2nd trimester and is avoided in 1st trimester due to the detrimental effect on organogenesis of fetus and the harmful effects of anaesthesia.
    METHODS: A 26 year old woman with advanced glaucomatous damage underwent trabeculectomy without antifibrotic agent in first trimester of pregnancy.
    RESULTS: The intraocular pressures (IOP) were well controlled during pregnancy with no need of addiitional antiglaucoma medications. She delivered a healthy baby at term with no congenital abnormality.
    CONCLUSIONS: Trabeculectomy without antifibrotic agents can be done in first trimester of pregnancy in cases where IOP cannot be controlled with topical antiglaucoma drugs that are considered safe during this period. This is the first report in literature on trabeculectomy in first trimester of pregnancy.
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  • 文章类型: Journal Article
    UNASSIGNED: This report describes a case of bilateral primary angle closure (PAC) progressing to unilateral end-stage primary angle closure glaucoma (PACG) associated with treatment for coronavirus disease-19 (COVID-19) infection.
    UNASSIGNED: A 64-year-old man came to our attention because of blurred vision after a 2-month hospital stay for treatment of COVID-19 infection. Examination findings revealed PACG, with severe visual impairment in the right eye and PAC in the left eye due to plateau iris syndrome. The patient\'s severe clinical condition and prolonged systemic therapy masked the symptoms and delayed the diagnosis. Medical chart review disclosed the multifactorial causes of the visual impairment. Ultrasound biomicroscopy (UBM) aided in diagnosis and subsequent therapy.
    UNASSIGNED: The cause behind the primary angle closure and the iridotrabecular contact was eliminated by bilateral cataract extraction, goniosynechialysis, and myotic therapy.
    UNASSIGNED: COVID-19 treatment may pose an increased risk for PAC. Accurate recording of patient and family ophthalmic history is essential to prevent its onset. Recognition of early signs of PAC is key to averting its progression to PACG.
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