Pigment dispersion syndrome and pigmentary glaucoma – a major review

Abstract

Pigment dispersion syndrome (PDS) is an interesting condition that can lead to secondary open angle glaucoma. Pigmentary glaucoma is primarily a disease of young people, myopes and men. PDS is characterized by the presence of Krukenberg spindles, iris trans-illumination defects, trabecular meshwork pigmentation and backward bowing of the iris. Posterior bowing of the iris causes rubbing of the pigmented iris epithelium against lens structures, liberation of pigment and trabecular meshwork changes that result in reduced aqueous outflow with the risk of glaucoma. Peripheral laser iridotomy can reverse backward bowing of the iris and may prevent progression of pigmentary glaucoma.

Bilateral acute iris transillumination (BAIT) initially misdiagnosed as acute iridocyclitis

“…It is usually asymptomatic and characterized by posterior bowing of the iris, Krukenberg's spindle, and slit-like, radial, midperipheral transillumination defects (6) , none of which were detected in our patient.…”

Bilateral acute depigmentation of the iris: a case report

“…A subsequent positive tran sillu mination test may be observed as a sequela of the posterior iris pig ment epithelium atrophy (7) . The pigment dispersion and pseudoexfoliation syndromes exhibit typical bilateral, irreversible, posterior iris pigment epithelium defects and a positive transillumination test on slit lamp exa mination (8) . The diagnosis of BADI is based on clinical features and may be challenging due to its rarity and the paucity of noted signs and symptoms.…”

Glaucoma: genes, phenotypes, and new directions for therapy

“…Pigment dispersion syndrome is an ocular condition characterized by shedding of pigment granules from the iris, which become distributed throughout the eye, including the trabecular outflow pathways (34). The presence of pigment in the outflow pathways causes an increase in IOP and glaucoma in approximately 50% of individuals affected with the condition (34). The condition can be inherited as an autosomal dominant trait, and one loci (GPDS1) has been identified; however, the causative gene has not yet been discovered (35).…”