Pseudoexfoliation syndrome prevalence in Greek patients with cataract and its association to glaucoma and coronary artery disease

Abstract

Purpose To investigate the prevalence of glaucoma and coronary artery disease (CAD) in patients with cataract and pseudoexfoliation (PEX) syndrome. Methods Cross-sectional study of 2140 consecutive patients with cataract admitted at the University Hospital of Patras, Greece, for cataract surgery. Only patients with senile cataract were included in this study. All patients underwent a complete ophthalmological examination that included slit-lamp evaluation with dilated pupil for PEX material in the anterior segment, intraocular pressure (IOP) measurements, and optic disc cup examination. They also underwent an evaluation for CAD by a cardiologist. CAD was considered present if a patient had a history of myocardial infarction, or ischaemia, or abnormal coronary angiography. The patients were classified into two groups: the PEX and the non-PEX group. Results One thousand and eighty-eight (50.8%) patients were men and 1052 (49.2%) were women. The overall prevalence of PEX syndrome was found to be 27.9% and it was found to increase with progressing age. Bilateral PEX was more frequent than unilateral PEX, with the percentage of bilateral PEX raising with progressing age. A total of 132 patients (22.1%) in the PEX group exhibited glaucoma, while in the non-PEX group only 2.5% suffered glaucoma. PEX was also found to be positively associated with the risk for CAD among subjects 50 years or older.No association between CAD and glaucoma was found. Conclusions PEX syndrome constitutes a major glaucoma risk factor and a CAD risk factor. Patients with PEX should be informed and examined frequently as the risk is present throughout.

Relationship between pseudo exfoliation syndrome of pupil and increased intraocular pressure and glaucoma in patients referred to ophthalmology clinic of Ardabil city hospital

“…[4][5][6][7][8][9][10][11][12][13][14][15][16][17] In studies done in other places, the prevalence of PXS has been increased with age increasing that has been in line with the results of present study. [4][5][6]9,10,[12][13]15,17 Different results obtained in previous studies in terms of the difference between the two sexes which sex difference has not been observed in some studies (Morano Montane study in Spain, Arvind H study in southern India, Susic N study in Croatia, but in some studies in line with this study, the disease is more common in women than in men (63/9% of men and 36/1% in women) which probably shows the different disease behaviors in present region and perhaps some other regions of the world.…”

“…In terms of developing glaucoma or elevated intraocular pressure similar to previous studies significant differences between the two groups were observed (2 eyes in the control group and 43 eyes in the case group) that this difference is meaningful and this indicates that the presence of PXS is an important risk factor for glaucoma or elevated intraocular pressure. 5,7,9,[12][13][14][15][16][17][18] In terms of C / D ratio above 5/10, the increase in the case group is significant (P=0.021), which indicates a lack of proper screening of patients or lack of referring the patients to measure intraocular pressure and the correct follow up and considering that in case of loss of optic nerve disease (high ratio C / D) , glaucoma is not returnable, so planning and designing of health authorities to screen at risk people, especially in elderly, and in case of the presence PXS, is absolutely necessary.…”

Serum YKL-40 levels as a novel marker of inflammation and endothelial dysfunction in patients with pseudoexfoliation syndrome

“…7,[22][23][24] In a previous study, PEX was found to be positively associated with the risk for cardiovascular diseases among patients with age Z50, and PEX was suggested as a risk factor for cardiovascular diseases. 25 To our best knowledge, we are the first to show the elevated serum YKL-40 levels, a new potential biomarker of inflammation and vascular dysfunction, in patients with PEX. In our study, PEX group had also elevated systolic and diastolic blood pressures, serum HsCRP, total cholesterol, LDL, and triglycerides levels, and reduced serum HDL levels, which were predictors for cardiovascular diseases.…”

Retinal vascular occlusions occur more frequently in the more affected eye in exfoliation syndrome

“…[7][8][9][10][11][12] Exfoliation material (XFM) is found not only in ocular tissues, [13][14][15] and several systemic disorders have been associated with XFS, such as peripheral vascular occlusions, increased carotid stiffness, coronary artery disease, stroke, Alzheimer's disease, and hearing loss. [16][17][18][19][20][21][22][23] The pathogeneses and clinical features of acute retinal vascular occlusions (RVOs) are still not well understood. 24,25 Central retinal vein occlusion (CRVO) has been described in eyes with XFS, even when exfoliative glaucoma (XFG, a known risk factor) was not present.…”