Pathophysiology of pigment dispersion syndrome and pigmentary glaucoma: Editorial review

Campbell, David G.; Schertzer, Robert M.

doi:10.1097/00055735-199504000-00015

Cited by 59 publications

(51 citation statements)

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“…"Active" pigment dispersion (ie, the detection over time of an increased amount of pigment deposition on anterior segment structures) seems to be a major risk factor for conversion. 18,19 Interestingly, Küchle and coworkers observed melanin granules in the anterior chamber of patients with PDS, the density being increased by pupillary dilatation. 20,21 However, as suggested by Schenker et al, "a pupillary movement, and the induced mechanical abrasion of pigment epithelium, while necessary to induce liberation of pigment, are not always sufficient to do so."…”

Section: Discussionmentioning

confidence: 99%

A 10-Year Follow-up to Determine the Effect of YAG Laser Iridotomy on the Natural History of Pigment Dispersion Syndrome

et al. 2014

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Prospective long-term analyses of the role of drug-induced mydriasis and laser peripheral iridotomy (LPI) are needed to identify and manage the eyes of patients with pigment dispersion syndrome (PDS) at risk for progressing to ocular hypertension.OBJECTIVE To assess the 10-year incidence of increased intraocular pressure (IOP) in the 2 eyes of patients with PDS, with 1 eye that underwent LPI and the other that did not. DESIGN, SETTING, AND PARTICIPANTSIn a randomized clinical trial in the glaucoma research unit at the University Hospital of Parma, Italy, 72 patients with PDS underwent phenylephrine testing. Of these 72 patients, 29 (58 eyes) tested positive for succeeding IOP elevation, and 43 (59 eyes) tested negative. For the 29 high-risk patients (all in both eyes), one eye was randomly assigned to LPI, and the fellow eye was left untreated. For the 43 low-risk patients, the affected eyes were left untreated.MAIN OUTCOMES AND MEASURES An IOP elevation of 5 mm Hg or higher vs baseline (daily phasing) was considered to be a significant increase (ie, an event). RESULTSIn the high-risk group, 3 of 21 eyes that underwent LPI (14.3%) and 13 of 21 untreated eyes (61.9%) showed an increase in IOP of 5 mm Hg or higher during the follow-up period; 4 of 35 low-risk eyes (11.4%) showed a similar increase. Event-free mean (SD) time was 7.99 (0.43) years for high-risk treated eyes, 3.89 (0.68) years for high-risk untreated eyes, and 7.16 (0.23) years for low-risk eyes. The log-rank test showed the following: P < .001 for treated high-risk eyes vs untreated high-risk eyes, P = .74 for treated high-risk eyes vs low-risk eyes, and P < .001 for untreated high-risk eyes vs low-risk eyes.CONCLUSIONS AND RELEVANCE At the end of the 10-year follow-up, (1) approximately one-third of the whole PDS patient population showed an IOP increase of 5 mm Hg or higher in at least 1 eye; (2) phenylephrine testing identified eyes at high risk for developing IOP elevation; and (3) LPI, when performed on high-risk eyes, reduced the rate of IOP elevation to the same level as the low-risk eyes.TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01053416

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Section: Discussionmentioning

confidence: 99%

A 10-Year Follow-up to Determine the Effect of YAG Laser Iridotomy on the Natural History of Pigment Dispersion Syndrome

et al. 2014

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“…Campbell postulated that reversal of this concavity would be the key to the management of PDS and suggested the use of peripheral iridotomies to relieve posterior bowing, mainly by equalising the pressure between anterior and posterior chambers. Biometric measurements of central and peripheral anterior chambers in patients with PDS [2][3][4] support this theory. Ultrasound biomicroscopy imaging has received much interest from those researching anterior and middle ocular segments of the eye.…”

Section: Introductionmentioning

confidence: 65%

Iris configuration in accommodation in pigment dispersion syndrome

Balidis

Bunce

Sandy

et al. 2002

Eye

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Purpose This study was conducted in order to investigate the effect of accommodation on the iris morphology and iridolenticular contact, in eyes with Pigment Dispersion Syndrome and Pigmentary Glaucoma, using high-resolution ultrasound. Methods We performed a prospective observational study, examining a group of 30 Pigment Dispersion Syndrome and Pigmentary Glaucoma patients (49 eyes) and a smaller group of eight 'normals' nonPigment Dispersion Syndrome patients (8 eyes). All patients underwent ultrasound biomicroscopy, before and during accommodation. Results The iris profile before accommodation was found convex in 48.5%, flat in 19.7% and concave in 31.8%. Following accommodation the iris configuration remained unchanged in 66.2%, increased in concavity in 20.3% and decreased in concavity in 13.5%. Conclusion The effect of accommodation on iris configuration and accommodation is highly variable. From our experience the measurement of iris configuration using ultrasound biomicroscopy may not be a useful method of evaluating the effect of different treatments on iris configuration.

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“…1 The disorder is characterized by disruption of iris pigment epithelium and deposition of pigment granules on the anterior segment structures. The incidence of PDS is 4-8 per 100,000 popu- lation.…”

Section: Discussionmentioning

confidence: 99%

“…About 60% -80% of patients are myopes and 20% are emmetropes. 1 The syndrome is characterized by the triad of deposition of pigment on the posterior corneal surface in a vertical line (Krukenberg's spindle), wide open angles on gonioscopy with uniform and heavy pigmentation of trabecular meshwork, slit like radial transillumination defects in the iris. Other ocular findings commonly observed are: relatively flat cornea, deep anterior chamber,and wide open angles.…”

Section: Discussionmentioning

confidence: 99%

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Pigment dispersion syndrome

Sandhya¹,

Krishna²,

Bhaskar³

2013

JCSR

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We report of the rare occurrence of pigment dispersion syndrome (PDS) with posterior subcapsular cataract in both eyes in a young male patient. The patient presented with complaints of progressive decrease in vision of one year duration. The patient also had high myopia with mild iridodonesis, phacodonesis and anterior insertion of zonules. Classical signs of PDS like Krukenberg's spindle on the posterior corneal surface were evident on slit lamp examination; transillumination defects in the iris could not be elicited by retroillumination as the iris was heavily pigmented. Gonioscopy revealed heavy and uniform pigmentation of trabecular meshwork. Evidence of a characteristic iris configuration on optical coherence tomography (OCT), namely, posterior bowing of iris in the mid periphery suggested the diagnosis of PDS. This case highlights the importance of OCT in identifying the iris configuration characteristically seen in PDS even in the absence of transillumination defects in the iris and reiterates the need to look for subtle signs like phacodonesis which are important when surgical intervention is planned.

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Pathophysiology of pigment dispersion syndrome and pigmentary glaucoma: Editorial review

Cited by 59 publications

References 0 publications

A 10-Year Follow-up to Determine the Effect of YAG Laser Iridotomy on the Natural History of Pigment Dispersion Syndrome

A 10-Year Follow-up to Determine the Effect of YAG Laser Iridotomy on the Natural History of Pigment Dispersion Syndrome

Iris configuration in accommodation in pigment dispersion syndrome

Pigment dispersion syndrome

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