Prevalence of pseudoexfoliation syndrome and its association with ocular and systemic diseases in Eskisehir, Turkey

Yıldırım, Nilgün; Yaşar, Erdoğan; Gürsoy, Hüseyin; Çolak, Ertuğrul

doi:10.18240/ijo.2017.01.21

Cited by 27 publications

(31 citation statements)

References 39 publications

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“…The results of the present study support this variability. The frequency of PXF syndrome in our study (22.1%) was higher than that in most other hospital-based studies, namely 7.4% in Lamba and Giridhar,[30] 6% in the 50–60-year-age group in Govetto et al ,[31] 6.45% in Pakistan,[32] 19.53% in Yemen,[33] 11% in Turkey,[34] 3.5% in Riyadh,[35] 1.5%, Northern Nigeria,[36] 4.14% in Upper Egypt,[37] and 1.87% in India[29] and higher in study by Gelaw and Tibebu 35.82%[38] and Sufi et al 26.32%. [39] The study by Lamba and Giridhar have stated prevalence of PXF on OPD basis, while the present study evaluated the frequency of PXF based on patients presenting for cataract surgery.…”

Section: Discussioncontrasting

confidence: 67%

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Frequency and surgical difficulties associated with pseudoexfoliation syndrome among Indian rural population scheduled for cataract surgery: Hospital-based data

Joshi

Singanwad

2019

Indian J Ophthalmol

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Purpose: To study the frequency and intraoperative difficulties associated with pseudoexfoliation (PXF) syndrome at a tertiary eye care center in a rural central India. Methods: This study included patients scheduled for cataract surgery who were diagnosed with PXF syndrome. All patients underwent a complete ophthalmologic evaluation, including slit-lamp examination, tonometry, gonioscopy, and ophthalmoscopy before the surgery. Cataract surgeries were performed by a single surgeon who reported the intraoperative difficulties. Results: In total, 1022 phakic eyes of 1823 patients were evaluated, 226 of whom (22.1%) were diagnosed with PXF syndrome. Most eyes ( n = 81, 35.8%) with PXF syndrome were ≥81 years old. Eighty-six eyes (38.1%) had bilateral involvement, whereas 70 (30.9%) had right or left eye involvement. Further, PXF material was distributed on the iris, pupil, and lens in 70 eyes (30.9%) and on the pupillary margin in 36 eyes (15.9%). The mean pupillary dilation was 5.1 (±1.4) mm in patients with PXF syndrome compared with 7.2 (±1.6) mm in those without it ( P = 0.03). Grade VI cataract was observed in 93 eyes (41.2%) and hypermature cataract was the most commonly observed cataract stage. Twenty-one eyes (9.3%) had increased intraocular pressure. Intraoperative difficulties were encountered in 62 eyes (27.4%) with poor pupillary dilation being the most common problem (32 eyes, 14.2%), followed by zonular dehiscence (18 eyes, 8%). Conclusion: This hospital-based study showed that PXF syndrome is common in Indian rural population and that the intraoperative complication rate in these patients is high.

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Section: Discussioncontrasting

confidence: 67%

“…[31] Similar observations were noted by Al-Shaer et al in Yemen, wherein 10.1% patients between 41 and 50 years old and 28.8% >81 years old had the syndrome,[33] as well as in other studies from North Nigeria,[36] Riyadh (Saudi Arabia),[35] South India,[6] Turkey, and Ethiopia. [3438]…”

Section: Discussionmentioning

confidence: 99%

Frequency and surgical difficulties associated with pseudoexfoliation syndrome among Indian rural population scheduled for cataract surgery: Hospital-based data

Joshi

Singanwad

2019

Indian J Ophthalmol

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“…Raised intraocular pressure is frequently expected in patients with PXF and the prevalence of glaucoma has been reported as high as 26% and up to 49% at the time of cataract surgery. 31 , 32 PXF is the most frequent cause of secondary glaucoma as the results of an increased outflow resistance due to the chronic deposition of pigmented material freed from iris and in addition of exfoliative material throughout the tra-becular meshwork, Schlemm canal and collector channels. 33 The estimated incidence of glaucoma in PXF patients is three to four times greater in patients with than without PXF.…”

Section: Introductionmentioning

confidence: 99%

Cataract surgery in patients with pseudoexfoliation syndrome: current updates

Fontana¹,

Coassin²,

Iovieno³

et al. 2017

OPTH

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Pseudoexfoliation is a ubiquitous syndrome of multifactorial origin affecting elderly people by increasing the risk of cataract and secondary glaucoma development. Despite modern techniques and technologies for cataract surgery, pseudoexfoliation syndrome represents a challenge for surgeons because of the increased weakness of the zonular apparatus and limited pupil dilation. Due to the inherent difficulties during surgery, the risk of vitreous loss in these patients is several times higher than in cataract patients without pseudoexfoliation. Using currently available surgical devices (ophthalmic viscosurgical device, iris retractors and ring dilators, capsular tension ring, etc.), the risk of intraoperative complications may be much reduced, allowing the surgeon to handle difficult cases with greater confidence and safety. This review analyzes the methodologic approach to the patient with zonular laxity with the aim of providing useful advices to limit the risks of intraoperative and postoperative complications. From the preoperative planning, to the intraoperative management of the small pupil and phacodonesis, and to the postoperative correction of capsule phimosis and intraocular lens dislocation, a step approach to the surgical management of pseudoexfoliation patients is illustrated.

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“…PEX is often associated with cataracts, which causes ocular involvement and systemic involvement [ 1 ]. The worldwide incidence of PEX varies according to regional population differences and genetic variations, and etiopathology maintains its place on the agenda as an important eye health problem that needs to be fully addressed [ 3 , 32 , 33 ]. In recent years, matrix metalloproteinases have moved to the top of the list of the most frequently studied molecules with regard to the etiopathology of this disease [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Pseudoexfoliation syndrome (PEX) is a systemic disease with a 5–25% prevalence in all societies worldwide (genetically linked and influenced by race, age, and environmental factors). PEX is characterized by a grayish-white, bran-like fibrillar extracellular material in the intraocular and extraocular structures such as the pupillary flank, lens anterior capsule, iridocorneal angle, ciliary body and zonules, anterior hyaloid face, trabecular meshwork, corneal endothelium, and lid conjunctiva [ 1 – 3 ].…”

Section: Introductionmentioning

confidence: 99%

Decorin, Tenascin C, Total Antioxidant, and Total Oxidant Level Changes in Patients with Pseudoexfoliation Syndrome

Oruc

Keser

Yusufoğlu

et al. 2018

Journal of Ophthalmology

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Purpose Pseudoexfoliation syndrome (PEX) is an eye disease that develops under the influence of regional population differences, genetic factors, age, and environmental factors and is characterized by visualization of a gray-white fibrogranular substance in the lens anterior capsule and/or pupil margin during anterior segment examination. The underlying biochemical mechanisms of the disease have not yet been fully elucidated. Therefore, this study was designed to show the changes in aqueous humor and blood serum levels of matrix metalloproteinases (decorin and tenascin C), total antioxidants (TAS), and total oxidants (TOS) in both cataract patients who have unilateral PEX material and cataract patients who do not have unilateral PEX material. Methods Biological samples were simultaneously collected from 22 cataract patients who had unilateral pseudoexfoliation (PEX patients) and 22 cataract patients who did not have unilateral pseudoexfoliation (control patients). From the collected biological samples, decorin (DEC) and tenascin C (TN-C) were measured with the enzyme-linked immunosorbent assay (ELISA) method, and TAS and TOS were measured with an autoanalyzer. Results When decorin, tenascin C, and TOS values of PEX patients were compared with those of control patients, there was a statistically significant increase in all three parameters. Conversely, TAS values showed a statistically significant decrease in PEX patients compared to controls. DEC, TN-C, TAS values, and TOS values were significantly higher in aqueous fluid than in blood in both the PEX patient and control groups. Conclusions We suggest that parameters such as DEC, TN-C, TAS, and TOS play a role in the etiopathology of pseudoexfoliation syndrome. Thus, bringing these increased levels of extracellular proteins and TOS and decreased levels of TAS back to within physiological limits can mediate the reorganization of the blood-aqueous fluid barrier and slow the progression of pseudoexfoliation syndrome.

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Prevalence of pseudoexfoliation syndrome and its association with ocular and systemic diseases in Eskisehir, Turkey

Abstract: This study is the first population-based, randomized trial in Turkey. Prevalence of PEX in patients over 40 years old was found to be 5.0%. Besides glaucoma and cataract, hypertension, hearing loss, using drugs for cardiac and psychiatric diseases were associated with PEX.

Cited by 27 publications

References 39 publications

Frequency and surgical difficulties associated with pseudoexfoliation syndrome among Indian rural population scheduled for cataract surgery: Hospital-based data

Frequency and surgical difficulties associated with pseudoexfoliation syndrome among Indian rural population scheduled for cataract surgery: Hospital-based data

Cataract surgery in patients with pseudoexfoliation syndrome: current updates

Decorin, Tenascin C, Total Antioxidant, and Total Oxidant Level Changes in Patients with Pseudoexfoliation Syndrome

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