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Kaufman AR, Ali Al-Djasim L, Rivkin AC, Al-Futais M, Venkataraman G, Vimalanathan M, Sahu A, Ahluwalia NS, Shakya R, Vajaranant TS, Wilensky JT, Edward DP, Aref AA. Pregnancy outcomes in the medical management of glaucoma: An international multicenter descriptive survey. Eur J Ophthalmol 2024; 34:471-479. [PMID: 37671417 DOI: 10.1177/11206721231199774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
PURPOSE To determine if glaucoma medications are associated with pregnancy and/or postnatal complications. METHODS Multicenter descriptive survey. Subjects were female patients 18-45 years who were previously pregnant with a diagnosis of glaucoma or ocular hypertension prior to pregnancy. Chart review queried diagnosis, glaucoma severity, and race. Survey questions were asked for each pregnancy and queried pregnancy age, medications used, and pregnancy outcomes/complications. RESULTS 114 pregnancies of 56 patients (mean 2.0 pregnancies per patient) were included. Three pregnancies with therapeutic abortion were excluded from further analysis. Mean age during pregnancy was 29.1 ± 5.7 years. Of the 111 pregnancies, 20 (18.0%) used no medications and 91 (82.0%) used at least one medication. Medications were topical carbonic anhydrase inhibitors (n = 45), beta-blockers (n = 55), alpha-agonists (n = 56), and prostaglandin analogues (n = 28). Outcomes were: preterm contractions/labour (6.3%), miscarriage (4.5%), stillbirth (4.5%), induction of labour (11.9%), emergency/unplanned caesarean delivery (13.9%), neonatal intensive care unit (NICU) stay (15.8%), congenital anomalies (8.1%), and low birth weight (10.9%). Fisher exact test assessed outcome associations with individual agents, use of any agent, and different number of agents. Alpha-agonist use was associated with NICU stay: 25.5% rate (p = 0.012) in alpha-agonist use. Most of the alpha-agonist use NICU stays occurred in pregnancies with third trimester use. All other associations were not statistically significant. CONCLUSIONS The data from this survey suggest an overall favourable safety profile for topical glaucoma medications in pregnancy, but further investigation is needed. Caution should be employed regarding third trimester alpha-agonist use owing to association with NICU stay.
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Affiliation(s)
- Aaron R Kaufman
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
| | - Leyla Ali Al-Djasim
- Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Angeline C Rivkin
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
| | - Muneera Al-Futais
- Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | | | | | - Abhipsa Sahu
- Department of Ophthalmology, Aravind Eye Hospital, Coimbatore, India
| | - Navjot Singh Ahluwalia
- Department of Ophthalmology, Shri Sadguru Seva Sangh Trust, Chitrakoot Centre, Chitrakoot, India
| | - Rakesh Shakya
- Department of Ophthalmology, Shri Sadguru Seva Sangh Trust, Chitrakoot Centre, Chitrakoot, India
| | - Thasarat Sutabutr Vajaranant
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
| | - Jacob T Wilensky
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
| | - Deepak P Edward
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
| | - Ahmad A Aref
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
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Khandekar R, Al Hassan A, Al Dhibi H, Al Bahlal A, Al-Futais M. Magnitude and determinants of diabetic retinopathy among persons with diabetes registered at employee health department of a tertiary Eye Hospital of central Saudi Arabia. Oman J Ophthalmol 2016; 8:162-5. [PMID: 26903721 PMCID: PMC4738660 DOI: 10.4103/0974-620x.169889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: To estimate the magnitude and determinants of diabetic retinopathy (DR) among persons with diabetes registered at the employee health department of King Khaled Eye Specialist Hospital (KKESH). Methods: A retrospective review of medical records was conducted in 2013–14 at KKESH. The case record review extracted demographic, profile of diabetes, diabetic complications, and different blood indices to determine the status of potential risk factors. Ocular profile, especially DR was also noted. Results: Our cohort had 94 staff with diabetes. Eye examination was carried out in 51 (54.8%) of them. The rate of DR was 52% (95% confidence interval (CI) 28–66). Sight-threatening diabetic retinopathy (STDR) (proliferative DR and/or diabetic macular edema) was present in 40% of those examined. Good glycemic control was noted in 42% of participants. Duration of diabetes was associated with DR (P = 0.04). Good glycemic control was negatively associated to DR (odds ratio = 0.2 [95% CI 0.04–0.6]). The coverage of eye screening was 55% only. Laser treatment was given to 80% of STDR cases. The lens opacity and glaucoma rate was 15% and 8.3%, respectively. Conclusions: Low coverage for eye screening and laser treatment to diabetics among the staff of an eye hospital is a matter of concern. The underlying causes of low coverage of screening, digital fundus photography as a screening tool and management should be addressed.
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Affiliation(s)
- Rajiv Khandekar
- Department of Research, Vitreoretinal and Employee Health, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Arif Al Hassan
- Department of Research, Vitreoretinal and Employee Health, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Hassan Al Dhibi
- Department of Research, Vitreoretinal and Employee Health, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Abdullah Al Bahlal
- Department of Research, Vitreoretinal and Employee Health, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Muneera Al-Futais
- Department of Research, Vitreoretinal and Employee Health, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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Al-Alawi A, Al-Hassan A, Chauhan D, Al-Futais M, Khandekar R. Knowledge, Attitude, and Perception of Barriers for Eye Care among Diabetic Persons Registered at Employee Health Department of a Tertiary Eye Hospital of Central Saudi Arabia. Middle East Afr J Ophthalmol 2016; 23:71-4. [PMID: 26957842 PMCID: PMC4759907 DOI: 10.4103/0974-9233.164629] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To evaluate the level of knowledge, attitudes, and barriers to diabetic retinopathy (DR) screening among diabetic healthcare staff at a tertiary eye hospital in central Saudi Arabia. METHODS This was a descriptive survey using a closed-ended questionnaire. A. 5-grade. Likert scale was used for responses to each question. Data were collected on patient demographics and the status of diabetes. Survey responses related to knowledge, attitude, and barriers were grouped. RESULTS The study sample was comprised of 45 diabetics employed at the hospital. The mean age was 49 ± 11 years and 33 diabetics were males. One-third of the study population was referred to the eye clinic for DR screening. DR screening was performed in 25% of diabetics over the previous year. Twenty-nine (64%; 95% confidence intervals: 50-78) participants had excellent knowledge of eyecare for diabetic complications. Thirteen percent of participants had a positive attitude toward periodic eye checkups. Travel distance to an eyecare unit, no referral from family physicians for annual eye checkups and the lack of availability of gender-specific eyecare professionals were the main perceived barriers. CONCLUSION Annual DR screening needs to be promoted to primary healthcare providers and diabetic patients. Barriers should be addressed to improve the uptake of DR screening.
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Affiliation(s)
- Abeer Al-Alawi
- Department of Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Arif Al-Hassan
- Department of Employee Health, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Deepti Chauhan
- Department of Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Muneera Al-Futais
- Department of Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Rajiv Khandekar
- Department of Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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