Pseudoexfoliation Syndrome and Antidepressant Drug Use

Konstas

Middle East African Journal of Ophthalmology

et al. 2021

The purpose of the study is to evaluate the risk factors associated with exfoliation in a case-cohort setting and literature review. This single-center, prospective, case-cohort study was carried out from January 2010 to April 2020 on patients operated for cataract surgery by a single surgeon in Lebanon. Forty-nine consecutive patients with exfoliation syndrome (XFS) and 62 consecutive control patients were identified and further investigated for selected systemic (diabetes mellitus, systemic hypertension, asthma, or atopy) and ocular variables (baseline vision, severity of nuclear sclerosis, glaucoma, eye rubbing, history of dry eye, or allergic eye disease). The mean baseline Snellen visual acuity was 20/283 in XFS versus 20/145 in control cases ( P = 0.012). XFS also demonstrated significantly denser nuclear sclerosis than controls ( P = 0.00958). By univariate analysis, allergic conjunctivitis (15 [30.6%] vs. 2 [3.2%]; P < 0.001), dry eye (20 [40.8%] vs. 13 [21.0%]; P = 0.0133), and habitual rubbing of the eyes (33 [67.3%] vs. 19 [30.6%]; P < 0.001) were associated with the presence of XFS. Habitual ocular rubbing was closely associated with allergic conjunctivitis (odds ratio [OR] = 13.0; 95% confidence interval [CI]: 2.8–58.8; P = 0.032). After multivariable analysis, the following variables showed significant results: glaucoma (OR = 34.5; 95% CI: 4.4–250; P = 0.010), duration of surgery (OR = 5.6; 95% CI 2.43–12.9; P < 0.001), and habitual ocular rubbing (OR = 4.42; 95% CI: 1.97–9.90; P = 0.029). This study shows a novel potential correlation between eye rubbing and XFS in a Lebanese cohort. Chronic eye rubbing induces or may exacerbate preexistent zonular damage in subjects with XFS, hence the need to better manage concurrent ocular surface disorder in these patients.

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Case–Cohort Study of Exfoliation Risk Factors and Literature Review

Konstas

Middle East African Journal of Ophthalmology

et al. 2021

“…When considering the patient-specific treatment schemes has gained importance in glaucoma management recently, the vascular parameters are gradually becoming important in terms of diagnosis, progression, and treatment algorithms especially in XFG, which is known to affect the vascular system more and cause increased vascular resistance. [18][19][20][21][22][23][24] Even a comprehensive slit-lamp examination is sufficient to diagnose XFS, and XFG is a clinical diagnosis depends on detection of glaucomatous damage; in particular cases with XFS it is hard to determine whether the VF defect is related with glaucoma or related with other co morbidities. Yarmohammadi et al 25 have found that that OCTA potentially shows promise for identifying focal glaucomatous damage before the first VF defect develops.…”

Section: Discussionmentioning

confidence: 99%

Cut-Off Values of Foveal Vascular Indices in Exfoliation Glaucoma

Kocatürk¹,

Zivkovic²,

Dayanir³

2021

OPTH

Purpose To compare the vascular measurements obtained from fovea including foveal avascular zone (FAZ) with optical coherence tomography angiography (OCTA) between patients with exfoliation glaucoma (XFG) and healthy controls. Methods This cross-sectional comparative study included 54 XFG patients and 94 healthy subjects. All subjects were given a complete ophthalmological examination including visual field testing, retinal nerve fiber layer and macular ganglion cell complex analysis. OCTA was performed to evaluate the vascular features of fovea including FAZ. The measurements of vessel density (VD), perfusion density (PD) and FAZ values were segmented and calculated using the inbuilt software on OCTA. Receiver operating characteristic (ROC) analyses were performed to determine the best cut-off values to detect the disease. Results In the XFG group, decreased VD, PD and FAZ values were observed. ROC analysis showed an obvious separation, differentiating the patients with XFG from the healthy controls at cut-off value of 19.55 with a sensitivity (sen) of 92.3% and a specificity (spe) of 81.9%) for VD total and 21.20 (sen:100 and spe:78.7) for VD parafoveal; 0.36 (sen:98.1and spe:76.6) for PDtotal and 0.378 (sen:96.2and spe:84) for PDparafoveal; 0.635 (sen: 79.3 and spe:72) for FAZ circulatory index. Conclusion The results support the findings of decreased microvascular density on foveal region in XFG. The cut off values of the changes in the foveal parameters in patients with exfoliation may be useful in evaluation of future glaucoma management to show how far a particular exfoliative eye is positioned from an healthy eye and how close to XFG.

Indian Journal of Ophthalmology

“…[ 12 ] Its concomitance with other systemic diseases such as hypertension (HT), cardiovascular disease (CVD), myocardial infarction (MI), peripheral vascular disease, ischemic brain disease (IBD), stroke, neurosensory hearing loss (NSHL), and depression suggests that PEX-S is a part of systemic diseases. [ 13 14 ]…”

mentioning

confidence: 99%

The use of calprotectin and other inflammatory parameters in the investigation of pseudoexfoliation syndrome concomitant glaucoma and systemic diseases

Yasar,

Erdal,

Tuncer

et al. 2023

Purpose: The present study aimed to investigate the value of calprotectin and other inflammatory parameters in patients with glaucoma and systemic diseases accompanying pseudoexfoliation syndrome (PEX-S). Methods: This prospective study included 45 PEX-S patients and 45 non-PEX control patients. Patients were investigated for the presence of glaucoma, cardiovascular disease (CVD), ischemic brain disease (IBD), Alzheimer’s disease, and neurosensory hearing loss (NSHL). After excluding diseases that may affect inflammatory parameters, a detailed biomicroscopic examination, and blood tests were performed for the patients. Results: Glaucoma, CVD, NVK, Alzheimer’s disease, and NSHL were high in the PEX-S group (P = 0.01, P = 0.01, P = 0.04, P = 0.04, and P = 0.03, respectively). Calprotectin, ferritin, neutrophil-to-platelet ratio, and lymphocyte-to-platelet ratio were found to be high in the PEX-S group (P < 0.01, P = 0.04, P < 0.01, and P < 0.01, respectively). On evaluating the relationship between PEX-S and glaucoma and systemic diseases, it was found that elevated calprotectin increased the risk of glaucoma by 4.36 times and elevated neutrophil-to-lymphocyte ratio (NLR) increased the risk of CVD by 3.23 times in PEX-S patients (P = 0.02 and P = 0.03, respectively). Conclusion: This study demonstrated the value of calprotectin elevation in detecting concomitant glaucoma in PEX-S patients and, in addition, the value of NLR elevation in detecting concomitant CVD.