Exercise and Reversed Pupillary Block in Pigmentary Glaucoma

Jensen, Patricia; Nissen, Ole I.; Kessing, Svend Vedel

doi:10.1016/s0002-9394(14)73767-5

Cited by 45 publications

(38 citation statements)

References 2 publications

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“…As part of the assessment of our patients, we did indeed exclude angle closure occurring during exercise (all patients had wide open drainage angles) and also excluded reverse pupillary block and also pigment dispersion induced by exercise. 1,2 In the absence of these features, we feel that the most probable aetiology of the exercise-induced visual loss we observed was a vascular steal effect and would again recommend that this phenomenon is considered in all patients presenting with the symptom of exercise-induced visual loss.…”

Section: Replymentioning

confidence: 82%

“…We read with interest the clinical study by Shah et al 1 reporting cases of exercise-related visual loss in patients with glaucoma. The visual functions, including visual acuity, foveal sensitivity and visual fields, of two patients were studied before and after exercise, and the results showed deterioration in the visual functions with exercise.…”

Section: Exercise-related Visual Loss In Patients With Glaucomamentioning

confidence: 99%

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Exercise-related visual loss in patients with glaucoma

Patel

McKibbin

2003

Eye

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Section: Replymentioning

confidence: 82%

Section: Exercise-related Visual Loss In Patients With Glaucomamentioning

confidence: 99%

Exercise-related visual loss in patients with glaucoma

Patel

McKibbin

2003

Eye

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“…Many previous studies [7][8][9][10][11][12] clearly showed that strenuous exercise, particularly exercise involving jarring movements, such as jogging or basketball [7,8,11], may result in massive pigment liberation accompanied by a rise in intraocular pressure. Pigment release appears to be associated with situations that result in significant iris movement.…”

Section: Discussionmentioning

confidence: 99%

“…Jensen et al [12] used ultrasound biomicroscopy to investigate the effect on iris contour of ten minutes of ergometric bicycle exercise (work load, 2.5 KPM, 60 cpm). However, no IOP measurement was performed.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of dapiprazole in preventing exercise-induced IOP increase in patients with pigmentary dispersion syndrome

et al. 1996

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The study supports the concept that exercise-induced pigment release temporarily obstructs the acqueous outflow channels, causing IOP increase in some patients with PDS. Pre-treatment with dapiprazole was useful in reducing IOP spikes and in increasing tonographic total outflow facility after exercise. The absence of induced myopia and the lack of dangerous vitreoretinal tractions on retinal periphery make dapiprazole a safe method to reduce exercise-induced pigment dispersion.

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“…Hierdurch entsteht ein Kontakt zwischen Zonulafasern und Irispigmentepithel mit der Folge der Freisetzung von Melaningranula in das Kammerwasser. Für dieses Konzept sprechen auch ultraschallbiomikroskopische Befunde [19, 251. Es wurde daher vorgeschlagen, den inversen Pupillarblock beim MDS durch eine Laseriridotomie zu beseitigen [11], was auch ultraschallbiomikroskopisch zu einer Normalisierung der Iriskonfiguration führen kann [3,4,5,12,15,17,24]. Neben der Iridotomie stellt die Therapie mit Miotika einen möglichen Ansatz dar, die Pathogenese des MDS zu durchbrechen: Durch eine Straffung des Irisdiaphragmas soll der Kontakt zwischen Iris und Zonulafasern reduziert und somit die weitere Freisetzung von Melaningranula in das Kammerwasser unterbunden werden.…”

Section: Diskussionunclassified

Number of aqueous melanin granules following treatment with aceclidine in eyes with primary pigment dispersion syndrome

Küchle

Nguyen

Mardin

et al. 2001

Spektrum Augeheilkd

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Zusammenfassung.Hintergrund: Das primäre Melanindispersionssyndrom ist durch eine Ausschwemmung von Melaningranula in die Vorderkammer charakterisiert. Die Anzahl dieser Melaningranula kann mit Hilfe der Laser-Tyndallometrie nichtinvasiv exakt quantifiziert werden. In dieser Studie untersuchten wir den Einfluss der antiglaukomatösen Therapie mit Aceclidin-Augentropfen auf die Zahl intracameraler Melaningranula bei Augen mit primärem Melanindispersionssyndrom.Patienten und Methode: Wir untersuchten 9 Augen von 6 Patienten (Durchschnittsalter 25,3±5,7 J,) mit primärem Melanindispersionssyndrom und sekundärem Offenwinkelglaukom. Die intracameralen Melaningranula wurden mit dem Zell-Zähl-Modus des Laser Flare-Cell Meters (Kowa FC-1000) vor und nach medikamentöser Pupillenerweiterung quantifiziert. Die Messungen erfolgten vor und im Durchschnitt 30,7 ± 8,9 Wochen nach Lokaltherapie mit Aceclidin 2% Augentropfen 3 X täglich.Ergebnisse: Vor Beginn der antiglaukomatösen Therapie fanden sich im Mittel 7,2 ± 4,9 Melaningranula (in 0,075 gl Kammerwasser) vor und 9,8 ± 5,7 Melaningranula nach Pupillenerweiterung. Unter Therapie mit Aceclidin zeigte sich eine signifikante Verringerung der Zahl der intracameralen Melaningranula auf durchschnittlich 2,9 ± 2,7 vor und 5,3 ± 4,3 nach Pupillenerweiterung (p < 0,03). Schlussfolgerungen: Eine Lokaltherapie mit Aceclidin Augentropfen führt bei Patienten mit primärem Melanindispersionssyndrom zu einer signifikanten Verringerung der Zahl intracameraler Melaningranula. Dies deutet darauf hin, dass Miotika eine wirksame Option der antiglaukomatösen Lokaltherapie bei ausgewählten Patienten mit diesem Krankheitsbild darstellen. Schlüsselwörter: Melanindispersionssyndrom, Pigmentdispersions syndrom, Melaningranula, Glaukom, Laser-Tyndallometrie. * Mit Unterstützung der Deutschen Forschungsgemeinschaft (Sonderforschungsbereich 539, Teilprojekt B L3). Number of aqueous melanin granules followingtreatment with aceclidine in eyes with primary pigment dispersion syndrome Summary. Background: Pigment dispersion syndrome is characterized by an increased number of aqueous melanin granules that may be reproducibly counted using the cell count mode of the laser flare-cell meter. lt was the aim of this study to analyse the effect of treatment with miotics (aceclidine) on the number of aqueous melanin granules in eyes with primary pigment dispersion syndrome.Methods: Nine eyes of 6 patients with a clinical diagnosis of primary pigment dispersion syndrome and secondary glaucoma (mean age 25.3 ± 5.7 y.) were included in this study. Aqueous cells were quantified using the "cell count mode" of the laser flare-cell meter (Kowa FC -1000) before and 30 minutes after medical pupillary dilation. Measurements were performed before and on average 30.7 ± 8.9 weeks after institution of treatment with aceclidine 2% eye drops three times daily.Results: The mean number of aqueous melanin granules/0.075 tl aqueous humor (normal/dilated pupil) before antiglaucoma treatment was 7.2 ± 4.9/9.8 ± 5.7 and was significantly r...

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Exercise and Reversed Pupillary Block in Pigmentary Glaucoma

Cited by 45 publications

References 2 publications

Exercise-related visual loss in patients with glaucoma

Exercise-related visual loss in patients with glaucoma

The effectiveness of dapiprazole in preventing exercise-induced IOP increase in patients with pigmentary dispersion syndrome

Number of aqueous melanin granules following treatment with aceclidine in eyes with primary pigment dispersion syndrome

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