Pseudoexfoliation syndrome and ocular adnexa

Abstract

Pseudoexfoliation syndrome (PEX) is a relatively widespread generalized age-related disease of connective tissue. It seems reasonable to evaluate the condition of ocular adnexa in patients with PEX. Purpose. To evaluate the condition of ocular adnexal tissue in PEX. Methods. 132 eyes of 66 patients with PEX syndrome and 128 eyes of 64 patients without it were enrolled in the prospective study. We evaluated function of upper eyelid levator muscle, lower eyelid retractors, horizontal lid laxity (HLL), canthal integrity, degree of retractors disinsertion and tone of orbicularis muscle. Results. HLL, degree of retractors disinsertion, laxity of medial canthal tendon were statistically significantly more expressed in patients with PEX (p < 0,05). The tone of orbicularis muscle and function of lower eyelid retractors were statistically lower in patients with PEX (p < 0,05). The function of eyelids levator muscle, tone of lateral canthal tendon and degree of ptosis were similar in both groups. Conclusion. Signs of atonic changes of ocular adnexa are relatively more common in patients with PEX (p < 0,05).

Changes in peri‑ocular anatomy and physiology in pseudoexfoliation syndrome (Review)

“…Furthermore, the tarsal attachments of the lower eyelid retractors may be weakened. On the other hand, PEX has not been associated with upper eyelid ptosis, possibly due to the fact that the upper eyelid retractors (levator palpebrae superioris, Muller's muscle) are comparatively stronger structures that are less likely to be affected by PEX fibrilopathy (38). Alteration in the anatomical stability of peri-ocular connective tissue elements complies with reports for similar extra-ocular changes, such as inguinal hernias ( 26) or pelvic organ prolapse in female patients (27).…”

“…The accumulation of pseudoexfoliative material in the peri-ocular connective tissues includes the medial and lateral canthal tendons, tarsal plates and orbicularis oculi muscle (33,38). A study has reported that PEX may be associated with atonic changes of the orbicularis oculi and compromise the stability of medial and lateral canthal tendons, resulting in horizontal and vertical lid laxity and predisposing to the development of eyelid margin malpositions, such as entropion or ectropion (Fig.…”

“…A study has reported that PEX may be associated with atonic changes of the orbicularis oculi and compromise the stability of medial and lateral canthal tendons, resulting in horizontal and vertical lid laxity and predisposing to the development of eyelid margin malpositions, such as entropion or ectropion (Fig. 3) (38). Furthermore, the tarsal attachments of the lower eyelid retractors may be weakened.…”

“…It has been associated with several pathogenetic mechanisms, including Dry Eye Disease (DED), drug toxicity, particularly from anti-glaucomatous medications, and viral infections, such as the human papillomavirus (40,41). Growing evidence has suggested that PEX may also be involved through combined pathological effects on all layers, including the tear film, corneal and conjunctival epithelium, as well as eyelid apposition to the eyeball (38). PEX has been reported to be implicated in OSD by several previous studies (40,42).…”

Клинические Особенности Органа Зрения У Пациентов С Псевдоэксфолиативным Синдромом: Литературный Обзор

“…Пациенты с ПЭГ по сравнению с пациентами с ПОУГ имеет худший прогноз из-за более высоких колебаний уровня ВГД и более тяжелого поражения зрительного нерва [ 23] . Кроме того, у пациентов с ПЭГ отмечается более высокий процент неудач медикаментозного лечения (простагландины, бета-блокаторы, адреномиметики и ингибиторы карбоангидразы) по сравнению с пациентами с ПОУГ [24 ] . Заключение.…”