Electron-microscopic Identification of Pseudoexfoliation Material in Extrabulbar Tissue

Schlötzer‐Schrehardt, Ursula; Küchle, Michael; Naumann, G. O. H.

doi:10.1001/archopht.1991.01080040133044

Cited by 163 publications

(123 citation statements)

References 24 publications

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“…Structural vascular abnormalities documented in eyes with XFS could be involved. [34][35][36] Immunohistochemistry analysis showed marked perivascular deposits of XFM involving the basement membrane of iris blood vessels in the involved eyes, but not in the uninvolved fellow eyes. 37 In addition, ocular blood flow 38 and ipsilateral carotid blood flow 39 have been reported to be reduced in the involved eye.…”

Section: Discussionmentioning

confidence: 98%

Retinal vascular occlusions occur more frequently in the more affected eye in exfoliation syndrome

Prata

Rozenbaum

Moraes

et al. 2009

Eye

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Purpose To evaluate the relationship between retinal vascular occlusions (RVOs) and exfoliation syndrome (XFS) in a cohort of patients with the two conditions. Methods We reviewed the records of patients with XFS with or without glaucoma and any type of RVO between 1983 and 2007. Patients with prior incisional surgery or a history of uveitis were excluded. Data collected included demographics, systemic comorbidities, type of RVO, and intraocular pressure (IOP) before the RVO. Slit-lamp biomicroscopy regarding the presence of exfoliation material on the lens capsule and pupillary margin before the vascular event was used to evaluate the laterality and degree of XFS. Results We identified 36 patients (mean age 78.4±8.3 years, 19 women). Most patients were of European descent (34/36) and 20 (56%) had no prior glaucoma diagnosis. The most common retinal vascular events were central retinal vein occlusion (18/36) and BRVO (10/36). Mean IOP between eyes with (19.5 ± 6.5 mm Hg) and without (17.9 ± 4.8 mm Hg) RVO was similar (P ¼ 0.12). RVOs occurred more commonly in the eye with more pronounced XFS in 92% (33/36) of the cases. A similar agreement was found when considering patients with and without glaucoma separately (94% (15/16) vs 90% (18/20); P ¼ 0.83). In addition, no difference in the agreement percentage was observed when comparing patients with unilateral XFS (87% (13/15)) with all study patients (P ¼ 0.87). Conclusions Retinal vascular occlusion in patients with XFS occurs most often in the affected or more severely affected eye.As vascular occlusions happened in patients with and without glaucoma in similar proportions, the presence of XFS seems to play an important role in these findings.

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Section: Discussionmentioning

confidence: 98%

Retinal vascular occlusions occur more frequently in the more affected eye in exfoliation syndrome

Prata

Rozenbaum

Moraes

et al. 2009

Eye

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“…Actually, the syndrome is rather bilateral with asymmetric presentation, as PEX fibres have been observed on electron microscopy in the conjunctiva 24 and orbital tissues 25 of the clinically uninvolved fellow eyes. Also immunohistochemical and ultrastructural findings, typical of PEX fibres, have been revealed in the iris of all unaffected fellow eyes.…”

Section: Discussionmentioning

confidence: 99%

“…4,15,24,25 But the association of PEX syndrome to vascular disease remains controversial. A possible link between PEX syndrome and cardiovascular or cerebrovascular disease has been supported by many sources.…”

Section: Discussionmentioning

confidence: 99%

Pseudoexfoliation syndrome prevalence in Greek patients with cataract and its association to glaucoma and coronary artery disease

Ανδρικόπουλος

Mela

Georgakopoulos

et al. 2007

Eye

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Purpose To investigate the prevalence of glaucoma and coronary artery disease (CAD) in patients with cataract and pseudoexfoliation (PEX) syndrome. Methods Cross-sectional study of 2140 consecutive patients with cataract admitted at the University Hospital of Patras, Greece, for cataract surgery. Only patients with senile cataract were included in this study. All patients underwent a complete ophthalmological examination that included slit-lamp evaluation with dilated pupil for PEX material in the anterior segment, intraocular pressure (IOP) measurements, and optic disc cup examination. They also underwent an evaluation for CAD by a cardiologist. CAD was considered present if a patient had a history of myocardial infarction, or ischaemia, or abnormal coronary angiography. The patients were classified into two groups: the PEX and the non-PEX group. Results One thousand and eighty-eight (50.8%) patients were men and 1052 (49.2%) were women. The overall prevalence of PEX syndrome was found to be 27.9% and it was found to increase with progressing age. Bilateral PEX was more frequent than unilateral PEX, with the percentage of bilateral PEX raising with progressing age. A total of 132 patients (22.1%) in the PEX group exhibited glaucoma, while in the non-PEX group only 2.5% suffered glaucoma. PEX was also found to be positively associated with the risk for CAD among subjects 50 years or older.No association between CAD and glaucoma was found. Conclusions PEX syndrome constitutes a major glaucoma risk factor and a CAD risk factor. Patients with PEX should be informed and examined frequently as the risk is present throughout.

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“…Light and electron microscopic studies have demonstrated the presence of pseudoexfoliation material in vorticose vein, central retinal artery, extraocular muscles, connective tissue of the orbit, skin, heart, lung, liver, and gallbladder (Ringvold 1972(Ringvold , 1973Layden & Shaffer 1974;Speakman & Ghosh 1976;Roh et al 1987;Streeten et al 1987Streeten et al , 1990Streeten et al , 1992Schlotzer-Schrehardt et al 1991.…”

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confidence: 99%

Iris indocyanine green angiography in pseudoexfoliation syndrome and capsular glaucoma

Parodi

Bondel

Saviano

et al. 2000

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: The iris vasculature shows typical changes in pseudoexfoliation syndrome (PXS) revealed by iris fluorescein angiography (IFA), such as hypoperfusion, microneovascularisation, and anastomotic vessels. Iris indocyanine green angiography (IICGA) can visualize more precisely details of the iris vascular pattern, especially as regards hypoperfusion and capillary dilatations. The aim of the present study is to describe the angiographic features of PXS on IFA and IICGA, comparing eyes affected with those not affected by capsular glaucoma. Methods: In a prospective study 42 consecutive patients affected by PXS underwent a complete ophthalmologic examination including IFA and IICGA. Thirty-two eyes were affected by capsular glaucoma. IICGA was performed using IMAGEnet System H1024. Results: IFA can easily detect the microneovascularisation, whereas IICGA allows a better recognition of iris hypoperfusion and anastomotic vessels, and it can reveal iris pigment epithelium defects. While the degree of hypoperfusion was similar in the two subgroups, eyes affected by capsular glaucoma more frequently showed signs of both microneovascularisation (marked stromal tufts and marked plexi), and of anastomotic vessels (peripheral loop, lesser circle and oblique vessels), with statistically significant difference. A clear correlation between hypoperfusion, microneovascularisation, and anastomotic vessels as regards site and extent was not noticed. Conclusions: A different angiographic pattern can be detected in PXS eyes with capsular glaucoma in comparison with eyes without it. Further studies are needed to correlate angiographic features revealed by IFA and IICGA, with clinical features.Key words: pseudoexfoliation syndrome -iris fluorescein angiography -iris indocyanine green angiography.

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Electron-microscopic Identification of Pseudoexfoliation Material in Extrabulbar Tissue

Cited by 163 publications

References 24 publications

Retinal vascular occlusions occur more frequently in the more affected eye in exfoliation syndrome

Retinal vascular occlusions occur more frequently in the more affected eye in exfoliation syndrome

Pseudoexfoliation syndrome prevalence in Greek patients with cataract and its association to glaucoma and coronary artery disease

Iris indocyanine green angiography in pseudoexfoliation syndrome and capsular glaucoma

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