Managing advanced unilateral pseudoexfoliative glaucoma.
The only proven therapy for glaucoma is intraocular pressure (IOP) reduction, which can be accomplished by different means. Each should be properly discussed with patients in order to best preserve visual function and quality of life. We report a case of unilateral pseudoexfoliative glaucoma, treated for years with triple topical IOP-lowering drugs. The patient presented with advanced optic neuropathy and important ocular side effects secondary to the treatment. Having discussed his options and prognosis, laser trabeculoplasty was performed while maintaining the remaining therapy considering the advanced stage of glaucoma. His IOP was effectively reduced and no progression was noted after 1-year follow-up. Although medical therapy is the mainstream in glaucoma management, its side effects should not be ignored, especially in unilateral cases. Surgery might have been a better solution, but we chose to perform laser trabeculoplasty, an effective and safer alternative, considering the unlikely but serious risk of the "wipe-out phenomenon" in this case.
Hospital de Egas Moniz, Lisboa, Portugal.
André
A
Marques
D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D017889:Exfoliation Syndrome / Q000150:complications / Q000628:therapy*; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000628:therapy*; D006801:Humans; D006983:Hypertrichosis / Q000139:chemically induced; D007429:Intraocular Pressure; D007499:Iris Diseases / Q000139:chemically induced; D000077338:Latanoprost; D008297:Male; D008875:Middle Aged; D010859:Pigmentation Disorders / Q000139:chemically induced; D011461:Prostaglandins F, Synthetic / Q000009:adverse effects / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use; D013843:Thiazines / Q000627:therapeutic use; D013999:Timolol / Q000627:therapeutic use; D014130:Trabeculectomy
D000959:Antihypertensive Agents; D002257:Carbonic Anhydrase Inhibitors; D011461:Prostaglandins F, Synthetic; D013449:Sulfonamides; D013843:Thiazines; D000077338:Latanoprost; D013999:Timolol; C111827:brinzolamide