Pseudo‐exfoliation, IOP and glaucoma

Abstract

On the basis of a glaucoma survey in a total population greater than or equal to 65 years of age, the IOP in eyes with and without pseudo-exfoliation (PE) has been compared. The average IOP was 22.2 mmHg in eyes with PE versus 17.4 in eyes without. The corresponding averages in eyes without glaucomatous damage were 18.6 and 17.1 mmHg, and in eyes with glaucoma 31.5 and 25.5 mmHg. The IOP elevation connected with the PE process was 4.8, 1.5, and 6.0 mmHg in the total, normal and glaucomatous population, respectively. The IOP frequency distribution curves of these 3 groups were compared. The right shift of the distribution curves of the PE groups was more pronounced at high pressure levels. The PE process seems to elevate the IOP particularly in eyes with a high IOP, which is in correspondence with hydrodynamical laws. At a certain IOP, the probability of having glaucomatous damage was higher in eyes with PE than in those without, indicating an increased vulnerability of PE eyes to an elevated IOP. PE may be a glaucoma risk factor also on its own, i.e. independent of the pressure elevation connected with this syndrome.

Ocular response analyzer to assess corneal biomechanical properties in exfoliation syndrome and exfoliative glaucoma

“…EXS is itself supposed to predispose the eye to glaucomatous damage even in the absence of elevated IOP [15,16]. The…”

Analysis of Retinal Nerve Fiber Layer Thickness in Patients with Pseudoexfoliation Syndrome Using Optical Coherence Tomography

“…They suggest that PXS may be a risk factor causing optic disk changes which are independent from IOP. Davanger et al [16] evaluated eyes with or without pseudoexfoliation, having equal IOP levels, and concluded that the optic nerve head in the eyes with pseudoexfoliation could be damaged more easily. In a study by Grødum et al [17], the glaucoma conversion rate was about twice as high in patients with ocular hypertension and pseudoexfoliation than in controls matched for IOP, age and gender.…”

Optic nerve head topography in nonglaucomatous, normotensive patients with unilateral exfoliation syndrome

“…Furthermore, Grodum et al (2005) [2] showed the glaucoma conversion rate to be twice as high in patients with OH (IOP 24-32 mmHg) and EXS as in non-EXS control patients matched for IOP, age, and gender (55.1% vs 27.6% in 8.7 years). Davanger et al [3], when examining normotensive and hypertensive patients in a population-based study, also concluded that EXS in itself may be a risk factor for optic nerve damage, as the likelihood of glaucomatous damage at equal IOP levels was greater in EXS than in non-EXS eyes. Likewise, Mitchell et al, in the Blue Mountains Eye Study [4] on hypertensive and normotensive patients, noticed a 5-fold increased risk for glaucoma in eyes with EXS, and this risk was independent of other known glaucoma risk factors.…”

“…In eyes with ocular hypertension (OH), EXS eyes develop glaucoma twice as often as non-EXS eyes (Pohjanpelto: 35% vs 18% in 9 years, Grodum et al: 55.1% vs 27.6% in 8.7 years) [1,2]. Moreover, in populationbased cross-sectional [3,4] and follow-up studies [5] with both normotensive and hypertensive patients with and without EXS included, EXS without the contributory effect of a raised IOP has been considered an independent risk factor for development of glaucoma. When examining nonglaucomatous, normotensive persons with unilateral EXS, we found slight glaucomatous changes in optic disc configuration in the EXS eyes compared to the non-EXS fellow eyes [6].…”