A case of secondary glaucoma caused by diabetic iritis treatment treated with mannitol and acetazolamide during pregnancy

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  • MIYAKE Ryuta
    Department of Obstetrics and Gynecology, Osaka Habikino Medical Center
  • YASUKAWA Hisayoshi
    Department of Obstetrics and Gynecology, Osaka Habikino Medical Center
  • MATSUBARA Sho
    Department of Obstetrics and Gynecology, Osaka Habikino Medical Center
  • FUJII Hajime
    Department of Obstetrics and Gynecology, Osaka Habikino Medical Center
  • NAGAI Akira
    Department of Obstetrics and Gynecology, Osaka Habikino Medical Center
  • AKADA Shinobu
    Department of Obstetrics and Gynecology, Osaka Habikino Medical Center

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Other Title
  • 妊娠中の糖尿病性虹彩炎治療により発症した続発緑内障に対し，マンニトールおよびアセタゾラミドを投与して母児ともに良好な転機を得た1例
  • 症例報告 妊娠中の糖尿病性虹彩炎治療により発症した続発緑内障に対し,マンニトールおよびアセタゾラミドを投与して母児ともに良好な転機を得た1例
  • ショウレイ ホウコク ニンシン チュウ ノ トウニョウビョウセイ コウサイエン チリョウ ニ ヨリ ハッショウ シタ ゾクハツ リョクナイショウ ニ タイシ,マンニトール オヨビ アセタゾラミド オ トウヨ シテ ボジ トモニ リョウコウ ナ テンキ オ エタ 1レイ

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Abstract

<p>We experienced a case of secondary glaucoma due to treatment for diabetic iritis in a pregnant woman that was treated with mannitol and acetazolamide. A 34-year-old woman (gravida 3, para 1) was diagnosed with overt diabetes in the first trimester of pregnancy when a blood test revealed an HbA1c level of 7.9%. At nine weeks of gestation, she complained of pain and lacrimation in the right eye and was diagnosed with diabetic iritis. Her symptoms were relieved by Tenon’s capsule steroid injection. At 20 weeks, her right eye pain exacerbated and intraocular pressure increased. She was diagnosed with secondary glaucoma and treatment with eye drops was started. Inspite of the treatment, the intraocular pressure gradually increased to the extent that she lost her vision temporarily. Systemic mannitol and acetazolamide treatment was initiated and her symptoms had resolved and intraocular pressure had decreased to what it was at 20 weeks. To maintain normal intraocular pressure and blood pressure during labor, labor induction had been introduced under a control of epidural anesthesia, and the patient had an alive infant. Pregnant women with diabetes mellitus should be tested for ocular diseases. Use of epidural anesthesia and labor induction is an option to facilitate successful delivery in pregnant women with glaucoma. [Adv Obstet Gynecol, 71 (3) : 253-258, 2019 (R1.8)]</p>

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