Pattern of Pseudoexfoliation Deposits on the Lens and Their Clinical Correlation- Clinical Study and Review of Literature

Abstract

PurposeTo study the clinical correlates of pattern of deposits over the lens in patients with pseudoexfoliation syndrome (PXF) or pseudoexfoliation glaucoma.MethodsThis retrospective observational study screened 346 patients with PXF seen in glaucoma clinic of a tertiary hospital from 2011–2013. Details like pattern of deposits, location on the lens surface and pupillary abnormalities in slit lamp photographs and their correlation with clinical and demographic variables, were analysed.ResultsA total of 84 eyes of 42 patients with bilateral PXF were included for the study. Glaucoma was seen in 30 eyes with baseline IOP of 24+3.8 mm Hg. Comparing the type of deposits, namely classical (n = 39 eyes), radial pigmentary (RP) form (n = 39 eyes) and combined classical and radial pigmentary (CR) forms (n = 6 eyes) of deposits, pupillary ruff atrophy was common in all forms while poor dilatation was rare in the RP type (n = 5 vs n = 25 in classical forms, p<0.001). Mean deviation (MD) was worse in the classical and CR form as compared to RP type with the latter presenting much earlier, 43±3.2 years vs 48±4.1 years in CR and 56±5.7 years in classical form, p<0.001. The baseline IOP in the RP group (18±2.3 mm Hg) was significantly lower than the other two forms (CR 20±3.2 mm Hg, classical 28±2.3 mm Hg), p<0.001, with only 2 eyes on anti-glaucoma drugs at presentation.ConclusionPattern of exfoliation deposits may indicate the stage and severity of the disease process in evolution with the RP representing an earlier/less severe form of pseudoexfoliation syndrome.

Clinical spectrum of pseudoexfoliation syndrome—An electronic records audit

“…The PXF forms were classified into three clinical phenotypes based on the clinical features described in our earlier study. [ 9 ] Briefly it is as follows- a) Radial pigmentary, RP, form (earlier described pre-granular form)–The clinical features pointing in these eyes would be radial pigments with or without pupillary ruff atrophy. b) RP with classical with early coalescence of pigmentary deposits into the classical form of peripheral exfoliation deposits or combined forms of classical with true exfoliation.c) Classical PXF with dandruff like deposits in the peripheral and /or central area but not restricted to pupillary ruff, lens surface or cornea.Eyes with clinically evident PXF and normal IOP/visual field and optic nerve were classified as those with pseudoexfoliation syndrome.…”

A study of clinical spectrum of pseudo exfoliation syndrome

“…In a retrospective observational study performed by Rao, AD. et al [14], out of 346 patients with pseudoexfoliation, the pupillary ruff atrophy was common in all forms of deposition. Rao, A et al [15], conducted a study in which slit-lamp examination identified 16 patients with pupillary ruff atrophy in 32 unilateral pseudoexfoliation cases and 38 of 59 bilateral cases.…”

Prevalence of spheroidal degeneration of cornea and its association with other eye diseases in tribes of Western Rajasthan

“…Pseudocapsular exfoliation does share some common clinical features with SDC – increased prevalence with age and greater prevalence in males – but in the absence of a known etiology, neither a causal relationship nor common etiological factors appear likely, in spite of the finding of pseudocapsular-like material in extraocular sites, namely the conjunctiva. [ 17 ]…”