Pigment dispersion syndrome and pigmentary glaucoma

Sowka, Joseph

doi:10.1016/s1529-1839(04)70023-8

Cited by 28 publications

(33 citation statements)

References 46 publications

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“…The source of this substance is multifocal and is believed to appear secondary to abnormal basal membrane constituents produced by aging epithelial cells [1]. PEX is diagnosed clinically by anterior segment examination, and is defined as the presence of grey-white fibrogranular pseudoexfoliation material on the anterior capsule of the lens and edges of the pupil [2,3]. The prevalence of PEX varies by population; however, PEX frequency increases with age and it is believed that an extremely significant relationship exists between age-related cataractous lens changes and PEX [4].…”

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Cataract Surgery and Possible Complications in Patients with Pseudoexfoliation Syndrome

Erkayhan¹,

Doğan²

2017

Eurasian J Med

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Objective: The aim of this study was to evaluate the demographic characteristics and intraoperative complications of cataract surgery in patients with pseudoexfoliation syndrome (PEX). Materials and Methods:Cases of 225 eyes (80 eyes with pseudoexfoliation and 145 eyes without pseudoexfoliation as the control group) that underwent phacoemulsification cataract surgery and IOL implantation at the Silifke State Hospital Ophthalmology Clinic between April 2011 and April 2013 were analysed retrospectively. Patients with a history of previous ocular surgeries, ocular trauma, uveitis, glaucoma or corneal pathology were not included in the study. All cataract procedures were performed by the same surgeon. Patients' age, gender, anterior segment and fundus findings in both eyes, presence of pseudoexfoliative material, pre-and postoperative day 1 intraocular pressure (IOP) and surgery notes were evaluated.Results: There were 51 (34.7%) males and 29 (38.6%) females among the PEX cataract patients, and 98 (65.3%) male and 47 (61.8%) female controls. The incidence of pseudoexfoliation was similar in women (38.2%) and men (34.7%) (p=0.660). The mean age was 74.64±6.8 in the PEX group and 68.95±7.5 in the control group. Mean age was significantly higher in the PEX group compared to controls (p<0.001). Poor pupil dilation occurred intra-operatively in 60 (75%) of the patients with pseudoexfoliation and in 17 (11.7%) of the control patients. Frequency of poor intraoperative pupil dilation was significantly higher in the PEX group (p<0.001). Intraoperative vitreous loss occurred in 7 (8.8%) PEX patients and 5 (3.4%) controls, but this difference was statistically insignificant (p=0.090).Conclusion: Surgeons should be aware of the potential complications of cataract procedures in patients with PEX. Caution should be taken at every stage of the surgery to prevent these complications, and surgeons should be knowledgeable and skilful in complication management should they arise.Keywords: Pseudoexfoliation, cataract surgery, poor pupil dilation, intraoperative complications ÖZ Amaç: Bu çalışmada Psödoeksfoliasyon sendromu (PES)'li katarakt olgularının demografik özelliklerinin ve katarakt ameliyatı sırasında gelişen komplikasyonların değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Bu çalışmada Silifke Devlet Hastanesi göz kliniğinde Nisan 2011 ve Nisan 2013 tarihleri arasın-da fakoemülsifikasyon ile katarakt cerrahisi ve İOL implantasyonu uygulanmış 81 psödoeksfoliasyonlu göz ile kontrol grubu olarak 145 psödoeksfoliasyonsuz göz toplam 226 göz retrospektif olarak incelendi. Önceden geçirilmiş göz cerrahisi, geçirilmiş göz travması, üveit, glokom, kornea patolojisi olan hastalar çalışmaya alınmadı. Katarakt ameliyatları tek bir cerrah tarafından uygulandı. Hastaların yaşı, cinsiyeti, her iki gözünün ön segment ve fundus bulguları, psödoeksfoliatif materyal varlığı, preoperatif-postoperatif 1. gün GİB, ameliyat notları değerlendirildi.Bulgular: Psödoeksfoliasyon sendromlu katarakt olgularının 51' si (%34,7) erkek, 29'i (%38,6) ...

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Cataract Surgery and Possible Complications in Patients with Pseudoexfoliation Syndrome

Erkayhan¹,

Doğan²

2017

Eurasian J Med

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“…When pigment accumulates within the anterior segment structures and the trabecular meshwork, it blocks aqueous outflow, resulting in an increase in intraocular pressure (IOP) and subsequent damage to the optic nerve and retinal ganglion cell death. 4,5 High IOP (>21 mm Hg) is the strongest and most consistent risk factor for glaucoma; and although not all patients exhibit ocular hypertension, the probability of retinal ganglion cell loss and optic nerve damage increases exponentially with higher IOP, thus all current glaucoma treatments involve the reduction of IOP.2,6 Timolol maleate, a nonselective b 1 and b 2 adrenergic receptor antagonist, applied topically to the eye, decreases IOP by reducing aqueous humor production by blocking of breceptors on the ciliary epithelium. Timolol maleate (Timoptic) has been viewed as the gold standard therapy for glaucoma 7 and is used as the clinical benchmark in ocular hypotensive medication-registration trials.…”

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A Neurobehavioral Analysis of the Prevention of Visual Impairment in the DBA/2J Mouse Model of Glaucoma

Wong¹,

Brown²

2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Timoptic-XE treatment was used to examine the relationship between age-related changes in intraocular pressure (IOP), retinal cell loss, visual ability, and neuronal labeling in the superior colliculus in the DBA/2J mouse model of pigmentary glaucoma.METHODS. Mice were administered Timoptic-XE (0.0%, 0.25%, or 0.50%) daily from 9 weeks to 12 months of age. Visual ability and IOP were evaluated at 3, 6, 9, and 12 months of age. Mice from each group were then given intraocular injections of wheat germ agglutinin conjugated to horseradish peroxidase (WGA-HRP), and estimates of the number of cells in the ganglion cell layer of the retina, WGA-HRP transneural labeling of cells, cell count, and cross-sectional area of Nissl-stained cells in the superior colliculus were obtained. RESULTS.Mice treated with 0.50% and 0.25% Timoptic-XE maintained a high level of performance in behavioral vision tasks, while 12-month-old untreated mice (0.0% Timoptic-XE) exhibited impaired visual performance. Timoptic-XE therapy reduced IOP and cell loss in the ganglion cell layer of the retina and prevented somal shrinkage and the decrease in WGA-HRP transneural labeling in the superior colliculus that occurred in untreated mice at 12 months of age.CONCLUSIONS. This study provides a comprehensive assessment of the efficacy of Timoptic-XE in DBA/2J mice by correlating age-related visual system changes in the retina and brain with changes in IOP and visual ability. These results showed that reducing IOP not only rescued retinal ganglion cell atrophy but also restored visual function and altered patterns of neurodegeneration that occur with blindness. (Invest Ophthalmol Vis Sci. 2012;53:5956-5966) DOI:10.1167/iovs.12-10020 G laucoma is the second leading cause of blindness after cataracts.1 Clinically, glaucoma is characterized by ''cupping'' of the optic nerve head and visual deterioration due to the progressive loss of retinal ganglion cells and axons. 2,3 Pigmentary glaucoma is caused by the liberation of melanin pigment through the mechanical disruption of the posterior iris by the lens zonules. When pigment accumulates within the anterior segment structures and the trabecular meshwork, it blocks aqueous outflow, resulting in an increase in intraocular pressure (IOP) and subsequent damage to the optic nerve and retinal ganglion cell death. 4,5 High IOP (>21 mm Hg) is the strongest and most consistent risk factor for glaucoma; and although not all patients exhibit ocular hypertension, the probability of retinal ganglion cell loss and optic nerve damage increases exponentially with higher IOP, thus all current glaucoma treatments involve the reduction of IOP.2,6 Timolol maleate, a nonselective b 1 and b 2 adrenergic receptor antagonist, applied topically to the eye, decreases IOP by reducing aqueous humor production by blocking of breceptors on the ciliary epithelium. Timolol maleate (Timoptic) has been viewed as the gold standard therapy for glaucoma 7 and is used as the clinical benchmark in ocular hypotensive medication-registr...

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“…Hallmarks of this disease include midperipheral iris transillumination defects and a heavily pigmented trabecular meshwork. The primary causes of these abnormalities are unknown, and the etiology is poorly understood (1,2). At the present time, the medical treatments of pigmentary glaucoma are the nonspecific reduction of intraocular pressure (IOP) 1 with aqueous suppressants, laser trabeculoplasty, and filtering surgery.…”

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Involvement of Inflammation, Degradation, and Apoptosis in a Mouse Model of Glaucoma

Zhou

Kong

et al. 2005

Journal of Biological Chemistry

132

113

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Pigment dispersion syndrome and pigmentary glaucoma

Cited by 28 publications

References 46 publications

Cataract Surgery and Possible Complications in Patients with Pseudoexfoliation Syndrome

Cataract Surgery and Possible Complications in Patients with Pseudoexfoliation Syndrome

A Neurobehavioral Analysis of the Prevention of Visual Impairment in the DBA/2J Mouse Model of Glaucoma

Involvement of Inflammation, Degradation, and Apoptosis in a Mouse Model of Glaucoma

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