The amount of lens exfoliation and chamber‐angle pigmentation in exfoliation syndrome with or without glaucoma

Abstract

Correlations of the amount of chamber-angle pigmentation and exfoliation material with IOP and with image analysis of the optic discs are reported in the paired eyes of 63 persons with unilateral exfoliation syndrome, and 35 patients with unilateral capsular glaucoma. The effect on IOP of phenylephrine-induced pigmentary dispersion is examined. Chamber-angle pigmentation was more pronounced in capsular glaucoma than in the nonglaucomatous exfoliation eyes (p < 0.01), although the amount of lens exfoliation was the same. In nonglaucomatous exfoliative eyes IOP correlated significantly with the amount of chamber-angle pigmentation (p < 0.01) and exfoliation material (p < 0.05). The nonglaucomatous exfoliative eyes with grade > or = 2 trabecular pigmentation and those with reduction of IOP on phenylephrine provocation had smaller rim areas and rim/disc area ratios than the fellow eyes (p < 0.05). Rather than the amount of exfoliation, the main risk factor for glaucoma seems to be the degree of chamber-angle pigmentation.

Clinical profile, management and outcomes of pseudoexfoliation syndrome with glaucoma in a tertiary eye care hospital

“…Further risk factor for glaucoma is higher grades of angle pigmentation leading to progressive glaucoma in around 50 % of cases. 8 PEX cases are at greater risk of RNFL thinning as found by OCT. 9 Cataracts were found commonly among the cases of PXF 10,11 and it is also associated with zonular dialysis during cataract surgical procedure and post-operative lens displacement. 12 The current research is performed to elucidate the clinical profiles and several difficulties in treatment of eyes with PXF syndrome and glaucoma in a tertiary eye care hospital.…”

Clinical profile, management and outcomes of pseudoexfoliation syndrome with glaucoma in a tertiary eye care hospital

“…Further risk factor for glaucoma is higher grades of angle pigmentation leading to progressive glaucoma in around 50 % of cases. 8 PEX cases are at greater risk of RNFL thinning as found by OCT. 9 Cataracts were found commonly among the cases of PXF 10,11 and it is also associated with zonular dialysis during cataract surgical procedure and post-operative lens displacement. 12 The current research is performed to elucidate the clinical profiles and several difficulties in treatment of eyes with PXF syndrome and glaucoma in a tertiary eye care hospital.…”

Latanoprost-induced changes in the iris and trabeculum: an electron-microscopic morphological study

“…With regard to decreased outflow, electron microscopy identifies exfoliation material deposited along the intertrabecular spaces and Schlemm's canal, as well as pigment deposits that are derived both from detached iris epithelial cells and from macrophages that have ingested liberated pigment granules [10][11][12][13][14]. These pigment deposits were further identified in the angle.…”

“…However, their role in the pathogenesis of PEG glaucoma has not yet been identified. In a study by Puska, it has been reported that PEX itself might also cause excessive pigment accumulation in the anterior chamber angle [10]. It is not known whether this pigmentation might cause an IOP increase like pigmentary glaucoma does and if it might mask the IOP-lowering effect of latanoprost.…”

Correlation between retinal nerve fiber layer thickness and anterior segment parameters in patients with pseudoexfoliation: A cross-sectional comparative study

“…[ 4 12 ] Furthermore, the mean RNFL thickness in PXG patients is low compared to the PXS patients. [ 16 ]…”

“…It has been established that there is a significant correlation between the pigmentation of angle structures and elevated IOP or rim thinning compared to the amount of PXF in the anterior segment. [ 16 17 18 ]…”

Clinical profile, management and outcomes of pseudoexfoliation syndrome with glaucoma in a tertiary eye care hospital

“…Further risk factor for glaucoma is higher grades of angle pigmentation leading to progressive glaucoma in around 50 % of cases. 8 PEX cases are at greater risk of RNFL thinning as found by OCT. 9 Cataracts were found commonly among the cases of PXF 10,11 and it is also associated with zonular dialysis during cataract surgical procedure and post-operative lens displacement. 12 The current research is performed to elucidate the clinical profiles and several difficulties in treatment of eyes with PXF syndrome and glaucoma in a tertiary eye care hospital.…”

Latanoprost-induced changes in the iris and trabeculum: an electron-microscopic morphological study

“…With regard to decreased outflow, electron microscopy identifies exfoliation material deposited along the intertrabecular spaces and Schlemm's canal, as well as pigment deposits that are derived both from detached iris epithelial cells and from macrophages that have ingested liberated pigment granules [10][11][12][13][14]. These pigment deposits were further identified in the angle.…”

“…However, their role in the pathogenesis of PEG glaucoma has not yet been identified. In a study by Puska, it has been reported that PEX itself might also cause excessive pigment accumulation in the anterior chamber angle [10]. It is not known whether this pigmentation might cause an IOP increase like pigmentary glaucoma does and if it might mask the IOP-lowering effect of latanoprost.…”

Correlation between retinal nerve fiber layer thickness and anterior segment parameters in patients with pseudoexfoliation: A cross-sectional comparative study

“…[ 4 12 ] Furthermore, the mean RNFL thickness in PXG patients is low compared to the PXS patients. [ 16 ]…”

“…It has been established that there is a significant correlation between the pigmentation of angle structures and elevated IOP or rim thinning compared to the amount of PXF in the anterior segment. [ 16 17 18 ]…”

Clinical profile, management and outcomes of pseudoexfoliation syndrome with glaucoma in a tertiary eye care hospital

“…Further risk factor for glaucoma is higher grades of angle pigmentation leading to progressive glaucoma in around 50 % of cases. 8 PEX cases are at greater risk of RNFL thinning as found by OCT. 9 Cataracts were found commonly among the cases of PXF 10,11 and it is also associated with zonular dialysis during cataract surgical procedure and post-operative lens displacement. 12 The current research is performed to elucidate the clinical profiles and several difficulties in treatment of eyes with PXF syndrome and glaucoma in a tertiary eye care hospital.…”

Latanoprost-induced changes in the iris and trabeculum: an electron-microscopic morphological study

“…With regard to decreased outflow, electron microscopy identifies exfoliation material deposited along the intertrabecular spaces and Schlemm's canal, as well as pigment deposits that are derived both from detached iris epithelial cells and from macrophages that have ingested liberated pigment granules [10][11][12][13][14]. These pigment deposits were further identified in the angle.…”

“…However, their role in the pathogenesis of PEG glaucoma has not yet been identified. In a study by Puska, it has been reported that PEX itself might also cause excessive pigment accumulation in the anterior chamber angle [10]. It is not known whether this pigmentation might cause an IOP increase like pigmentary glaucoma does and if it might mask the IOP-lowering effect of latanoprost.…”

Correlation between retinal nerve fiber layer thickness and anterior segment parameters in patients with pseudoexfoliation: A cross-sectional comparative study

“…[ 4 12 ] Furthermore, the mean RNFL thickness in PXG patients is low compared to the PXS patients. [ 16 ]…”

“…It has been established that there is a significant correlation between the pigmentation of angle structures and elevated IOP or rim thinning compared to the amount of PXF in the anterior segment. [ 16 17 18 ]…”