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Pattern of pseudoexfoliation deposits on the lens and their clinical correlation--clinical study and review of literature.

Rao A, Padhy D - PLoS ONE (2014)

Bottom Line: Comparing the type of deposits, namely classical (n = 39 eyes), radial pigmentary (RP) form (n = 39 eyes) and combined classical and radial pigmentary (CR) forms (n = 6 eyes) of deposits, pupillary ruff atrophy was common in all forms while poor dilatation was rare in the RP type (n = 5 vs n = 25 in classical forms, p < 0.001).Mean deviation (MD) was worse in the classical and CR form as compared to RP type with the latter presenting much earlier, 43 ± 3.2 years vs 48 ± 4.1 years in CR and 56 ± 5.7 years in classical form, p < 0.001.The baseline IOP in the RP group (18 ± 2.3 mm Hg) was significantly lower than the other two forms (CR 20 ± 3.2 mm Hg, classical 28 ± 2.3 mm Hg), p < 0.001, with only 2 eyes on anti-glaucoma drugs at presentation.

View Article: PubMed Central - PubMed

Affiliation: Glaucoma Service, LV Prasad Eye Institute, Patia, Bhubaneswar, Odisha, India.

ABSTRACT

Purpose: To study the clinical correlates of pattern of deposits over the lens in patients with pseudoexfoliation syndrome (PXF) or pseudoexfoliation glaucoma.

Methods: This retrospective observational study screened 346 patients with PXF seen in glaucoma clinic of a tertiary hospital from 2011-2013. Details like pattern of deposits, location on the lens surface and pupillary abnormalities in slit lamp photographs and their correlation with clinical and demographic variables, were analysed.

Results: A total of 84 eyes of 42 patients with bilateral PXF were included for the study. Glaucoma was seen in 30 eyes with baseline IOP of 24+3.8 mm Hg. Comparing the type of deposits, namely classical (n = 39 eyes), radial pigmentary (RP) form (n = 39 eyes) and combined classical and radial pigmentary (CR) forms (n = 6 eyes) of deposits, pupillary ruff atrophy was common in all forms while poor dilatation was rare in the RP type (n = 5 vs n = 25 in classical forms, p < 0.001). Mean deviation (MD) was worse in the classical and CR form as compared to RP type with the latter presenting much earlier, 43 ± 3.2 years vs 48 ± 4.1 years in CR and 56 ± 5.7 years in classical form, p < 0.001. The baseline IOP in the RP group (18 ± 2.3 mm Hg) was significantly lower than the other two forms (CR 20 ± 3.2 mm Hg, classical 28 ± 2.3 mm Hg), p < 0.001, with only 2 eyes on anti-glaucoma drugs at presentation.

Conclusion: Pattern of exfoliation deposits may indicate the stage and severity of the disease process in evolution with the RP representing an earlier/less severe form of pseudoexfoliation syndrome.

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Related in: MedlinePlus

Figures showing additional features of classical pseudoexfoliation like slit shaped empty spaces (arrow in top left), anterior curling of the exfoliation sheet (blue arrow, top right) with pin-point deposits in a wave like pattern anterior to the sheet (small white arrow) which on higher magnification shows globular protrusions at the end of a stalk arising from the edge of the wave (arrows in bottom left and right).
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pone-0113329-g001: Figures showing additional features of classical pseudoexfoliation like slit shaped empty spaces (arrow in top left), anterior curling of the exfoliation sheet (blue arrow, top right) with pin-point deposits in a wave like pattern anterior to the sheet (small white arrow) which on higher magnification shows globular protrusions at the end of a stalk arising from the edge of the wave (arrows in bottom left and right).

Mentions: Analysing pattern of deposits, a total of 39 eyes had classical deposits (Figure 1,2 & Figure S1) while 39 had radial pigments (henceforth termed RP form, Figure 3 & Figure S2). Six eyes of 5 patients presented with combined features of classic and pigmentary deposits (henceforth termed CR form, Figure 4). There was no difference in the extent of TM pigmentation on gonioscopy between the different forms of the disease with all eyes displaying severe pigmentation at the angle.


Pattern of pseudoexfoliation deposits on the lens and their clinical correlation--clinical study and review of literature.

Rao A, Padhy D - PLoS ONE (2014)

Figures showing additional features of classical pseudoexfoliation like slit shaped empty spaces (arrow in top left), anterior curling of the exfoliation sheet (blue arrow, top right) with pin-point deposits in a wave like pattern anterior to the sheet (small white arrow) which on higher magnification shows globular protrusions at the end of a stalk arising from the edge of the wave (arrows in bottom left and right).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4257528&req=5

pone-0113329-g001: Figures showing additional features of classical pseudoexfoliation like slit shaped empty spaces (arrow in top left), anterior curling of the exfoliation sheet (blue arrow, top right) with pin-point deposits in a wave like pattern anterior to the sheet (small white arrow) which on higher magnification shows globular protrusions at the end of a stalk arising from the edge of the wave (arrows in bottom left and right).
Mentions: Analysing pattern of deposits, a total of 39 eyes had classical deposits (Figure 1,2 & Figure S1) while 39 had radial pigments (henceforth termed RP form, Figure 3 & Figure S2). Six eyes of 5 patients presented with combined features of classic and pigmentary deposits (henceforth termed CR form, Figure 4). There was no difference in the extent of TM pigmentation on gonioscopy between the different forms of the disease with all eyes displaying severe pigmentation at the angle.

Bottom Line: Comparing the type of deposits, namely classical (n = 39 eyes), radial pigmentary (RP) form (n = 39 eyes) and combined classical and radial pigmentary (CR) forms (n = 6 eyes) of deposits, pupillary ruff atrophy was common in all forms while poor dilatation was rare in the RP type (n = 5 vs n = 25 in classical forms, p < 0.001).Mean deviation (MD) was worse in the classical and CR form as compared to RP type with the latter presenting much earlier, 43 ± 3.2 years vs 48 ± 4.1 years in CR and 56 ± 5.7 years in classical form, p < 0.001.The baseline IOP in the RP group (18 ± 2.3 mm Hg) was significantly lower than the other two forms (CR 20 ± 3.2 mm Hg, classical 28 ± 2.3 mm Hg), p < 0.001, with only 2 eyes on anti-glaucoma drugs at presentation.

View Article: PubMed Central - PubMed

Affiliation: Glaucoma Service, LV Prasad Eye Institute, Patia, Bhubaneswar, Odisha, India.

ABSTRACT

Purpose: To study the clinical correlates of pattern of deposits over the lens in patients with pseudoexfoliation syndrome (PXF) or pseudoexfoliation glaucoma.

Methods: This retrospective observational study screened 346 patients with PXF seen in glaucoma clinic of a tertiary hospital from 2011-2013. Details like pattern of deposits, location on the lens surface and pupillary abnormalities in slit lamp photographs and their correlation with clinical and demographic variables, were analysed.

Results: A total of 84 eyes of 42 patients with bilateral PXF were included for the study. Glaucoma was seen in 30 eyes with baseline IOP of 24+3.8 mm Hg. Comparing the type of deposits, namely classical (n = 39 eyes), radial pigmentary (RP) form (n = 39 eyes) and combined classical and radial pigmentary (CR) forms (n = 6 eyes) of deposits, pupillary ruff atrophy was common in all forms while poor dilatation was rare in the RP type (n = 5 vs n = 25 in classical forms, p < 0.001). Mean deviation (MD) was worse in the classical and CR form as compared to RP type with the latter presenting much earlier, 43 ± 3.2 years vs 48 ± 4.1 years in CR and 56 ± 5.7 years in classical form, p < 0.001. The baseline IOP in the RP group (18 ± 2.3 mm Hg) was significantly lower than the other two forms (CR 20 ± 3.2 mm Hg, classical 28 ± 2.3 mm Hg), p < 0.001, with only 2 eyes on anti-glaucoma drugs at presentation.

Conclusion: Pattern of exfoliation deposits may indicate the stage and severity of the disease process in evolution with the RP representing an earlier/less severe form of pseudoexfoliation syndrome.

Show MeSH
Related in: MedlinePlus