- Design
- Retrospective cohort with mixed-effect Cox regression
- Population
- 92 women (184 eyes) who were glaucoma suspects before pregnancy
- Primary outcome
- Progression to glaucoma after pregnancy
- Effect
- 57.6% progressed; pre-eclampsia HR 4.30 (95% CI 2.33 to 7.93); mean IOP HR 1.37 (1.26 to 1.49)
This retrospective cohort followed 92 women (184 eyes) who were glaucoma suspects before pregnancy. Of these, 53 (57.6%) progressed to glaucoma, after a mean of 2.4 years.
In adjusted Cox models, higher mean intraocular pressure (HR 1.37 per unit, 95% CI 1.26 to 1.49) and pre-eclampsia (HR 4.30, 95% CI 2.33 to 7.93) were independent risk factors, and higher pre-pregnancy BMI looked protective (HR 0.91, 95% CI 0.83 to 0.99). The two main risks interacted (HR 1.19). Cumulative glaucoma incidence was higher after pre-eclampsia.
This is a small single-centre cohort, and the high progression rate reflects who was referred and followed. It suggests closer postpartum review of women with pre-eclampsia and glaucoma suspicion, and it should not be used to predict risk in the general population.
- Ask glaucoma suspects about pre-eclampsia and arrange eye review after delivery.
- Track intraocular pressure over time, since higher mean pressure carried the highest hazard.
- Do not apply the 57.6% progression figure to all glaucoma suspects.
- Tell obstetric teams about the link so postpartum eye follow-up is not missed.
Why it matters
Pregnancy is a time when eye follow-up often lapses, just when risk may be changing.
Don't overread it
Single-centre, 92 women, no comparison group of non-pregnant suspects; it shows association, not that pregnancy causes glaucoma.
The statistics, in plain English
A hazard of 4.30 means the rate of progressing was about four times higher with pre-eclampsia, after adjustment. The BMI result (HR 0.91) has a confidence interval close to 1 and may not hold up in other groups.
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