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Influence of Pregnancy on the IOP and Visual Field in a Patient Suffering from Glaucoma with Rieger's Syndrome

Pecold-Stepniewska H., Przybylska-Rybczynska I., Pecold K.,
K. Marcinkowski University of Medical Sciences Poznan, Department of Ophthalmology (Poznan)

Introduction: Pregnancy is known to lower the IOP. Our report presents a case of a 20 year old female patient with glaucoma in Rieger's syndrome and the examination results of IOP, visual field and optic disc picture during pregnancy.
Case report: A female patient suffering from Rieger's syndrome (pseudopolycoria, corectopia, hypodontia, microdontia, maxillary hypoplasia) has been followed in our clinic since her 11 years of age. At the age of 12 the first operation of right eye trabeculectomy was performed. Subsequent operations followed due to unstable IOP and progressing visual field loss: repeat right eye trabeculectomy with mitomycin, left eye cyclophotocoagulation and trabeculectomy with mitomycin. Despite the performed procedures target IOP in the left eye was only obtained by introducing topical pharmacotherapy with B-blockers and dorzolamide. Right eye IOP was normal without pharmacological treatment. In the second month of gestation all antiglaucomatous drugs were discontinued. IOP was examined monthly while visual field bimonthly.
Results: During pregnancy without the application of local therapy IOP showed: in the right eye 15,7±2,05 , in the left eye 20,25±2,55 mm Hg. No progression in the visual field loss was observed. Only a year after childbirth new scotomas were present despite obtaining IOP curve in the left eye similar to that observed during pregnancy. Therefore, antiglaucomatous drugs were instituted again into the left eye.
Conclusions: Our observations of glaucoma in a very rare Rieger's syndrome contribute to the conclusion thet pregnancy helps stop the progression of glaucomatous changes.