Глаукома

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Pregnancy and glaucoma

Martha M. Wright, MD, referred glaucoma specialists to the FDA’s classification system of drug safety during pregnancy.
Know the classifications. Brimonidine is the best choice among glaucoma medications; it is in class B (defined as “no evidence of risk in humans”). Most other glaucoma drugs are class C (defined as “risk cannot be ruled out”). Mitomycin C and 5-fluorouracil are class X and thus are contraindicated during pregnancy.
Know the impact on infants. Beta-blockers are actively secreted and concentrated in breast milk; as a result, infants of treated mothers should be monitored for apnea and bradycardia. Mothers who plan to nurse and are taking brimonidine should be taken off the drug at delivery, as brimonidine can cause apnea in infants, Dr. Wright said.
Plan ahead. It’s essential to talk with young female glaucoma patients before they become pregnant, Dr. Wright said. “And revisit the topic periodically and with any change in medication.”—Jean Shaw