Static and dynamic pupil characteristics in pseudoexfoliation syndrome and glaucoma

Abstract

Background To compare the static and dynamic pupillometry measurements in patients with pseudoexfoliation syndrome (PES), patients with pseudoexfoliation glaucoma (PEG) and age‐matched healthy subjects using an automatic quantitative pupillometry system. Methods This prospective, cross‐sectional study consisted of 40 patients with PES, 30 patients with PEG and 43 control subjects. Static pupillometry measurements including scotopic pupil diameter, mesopic pupil diameter, low photopic pupil diameter, and high photopic pupil diameter were undertaken. Subsequently, dynamic pupillometry measurements including resting diameter, amplitude of pupil contraction, latency of pupil contraction, duration of pupil contraction, velocity of pupil contraction, latency of pupil dilation, duration of pupil dilation, and velocity of pupil dilation were undertaken. These measurements were compared between the groups. Results The scotopic, mesopic, and low photopic pupil diameter values were statistically significantly lower in patients with PES and PEG compared with controls (p < 0.001). However, these parameters were similar between the patients with PES and PEG (p > 0.05). The mean values of high photopic pupil diameter were similar within all groups (p = 0.54). The amplitude of pupil contraction values of the patients with PEG was statistically significantly lower than the patients with PES and the controls (p < 0.05). Patients with PES also had significantly lower amplitude of pupil contraction values compared with controls (p < 0.001). Additionally, the velocity of pupil contraction values was statistically significantly higher in control subjects when compared to the patients with PES and PEG (p < 0.05). Conclusion This study demonstrated that accumulation of pseudoexfoliative material can cause alterations in static and dynamic pupillary characteristics and the progression from PES to PEG may be associated with reduced amplitude of pupil contraction values.

Dynamic volume‐rendered optical coherence tomography pupillometry

“…Eyes with PEXG showed significant reduced amplitude of pupil contraction values compared to healthy eyes (Tekin et al. 2018, 2019). This could be helpful in the evaluation of spatial conditions prior to cataract surgery and aid in the estimation of the success rate of drug or surgical pupil extension interventions at an early stage (Akman et al.…”

“…Typically, in anterior ischaemic optic neuropathy (AION), an incomplete pupil response due to ischaemic damage of the optic nerve head perfusion is found (Tsika et al 2015). A pathologic PLR has also been found in glaucoma (Kankipati et al 2011;Tekin et al 2019), retinitis pigmentosa (Kardon et al 2011;Kawasaki et al 2012), and age-related macular degeneration (AMD) (Maynard et al 2015). In pseudoexfoliation (PEX) syndrome, pupil malfunction occurs due to the accumulation of fibrillogranular material causing infiltration and fibrosis of the iris (Scharfenberg et al 2019).…”

A transcriptome atlas of the mouse iris at single-cell resolution defines cell types and the genomic response to pupil dilation

“…In humans, PDS also has a genetic component, but the contributing genes are still largely unknown ( Tandon et al, 2019 ; van der Heide et al, 2021 ). A conceptually similar disorder, exfoliation syndrome, is characterized by impaired pupil constriction and by the release of extracellular matrix material from the iris and lens, which accumulates in the trabecular meshwork and can lead to open angle glaucoma ( Kivelä, 2018 ; Schlötzer-Schrehardt, 2018 ; Tekin et al, 2020 ). Exfoliation syndrome has a strong genetic component, with seven loci identified in genome-wide association studies ( Aboobakar et al, 2017 ).…”

Ophthalmic Viscosurgical Devices (OVDs) in Challenging Cases: a Review

“…The pseudoexfoliation syndrome (PSX) is a complex age-related disorder characterized by the progressive accumulation of abnormal extracellular pseudoexfoliative material in ocular tissues, including the ciliary body, iris, iridocorneal angle, and lens capsule [ 40 ]. This may complicate the performance of cataract surgery due to pupillary abnormalities generated by this condition, such as significant miosis and a limitation of the dynamic pupillary pattern [ 40 ]. Indeed, iris hooks or Malyugin rings are sometimes needed for a mechanical pupil dilation allowing the surgeon to have an adequate visualization of the anterior segment [ 41 ].…”