Clinical characteristics and results of laser peripheral iridotomy of pigment dispersion syndrome

Şerife Bayraktar; Selver Selen Çağman; Belgin İzgi; Gülhan Örekici Temel

doi:10.28982/josam.345034

Authors

Şerife Bayraktar Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology
Selver Selen Çağman
Belgin İzgi
Gülhan Örekici Temel

DOI:

https://doi.org/10.28982/josam.345034

Keywords:

glaucoma, pigment dispersion syndrome, laser peripheral iridotomy

Abstract

Aims: To report the clinical findings, characteristics and the results of peripheral laser iridotomy in pigment dispersion syndrome (PDS) patients.

Methods: Medical records of 30 patients who had been diagnosed with PDS were evaluated retrospectively at Glaucoma Department of Istanbul Faculty of Medicine at Istanbul University.

Results: Sixty eyes of these 30 patients enrolled in the study. 18 of them (60%) were male and 12 (40%) were female with mean age of 42.4 ±12.3 years (range: 22 to 73 years). Forty-six eyes of the 23 patients had myopia, 12 eyes of 6 patients had hyperopia, 2 eyes of 1 patient had emmetropia. All patients except 2 eyes of the 1 patient had (96.6%) Krukenberg spindles. Homogeneous trabecular meshwork(TM) pigmentation was seen in all patients. Thirty-two eyes of 17 patients (53.3 %) had iris transillumination defects. Neodymium:yttrium–aluminum–garnet (Nd:YAG) peripheral laser iridotomy was performed in 44 eyes of 60 eyes (73.3%).

Conclusion: The most common clinical findings in Turkish PDS patients were Krukenberg spindles and homogeneous TM pigmentation. If PDS hasn’t advanced in pigmentary ocular hypertension or pigmentary glaucoma, progression can be stabilized by laser iridotomy and medical treatment.

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References

Fine BS, Yanoff M, Sheie HG. Pigmentary "glaucoma": A histologic study. Trans Am Acad. Ophthalmol Otolaryngol.1974; 7:314-325.

Niyadurupola N, Broadway DC. Pigment dispersion syndrome and pigmentary glaucoma-a major review. Clinic Experiment Ophthalmol2008; 36: 868–82.

Scuderi G, Papale A, Nucci C, Cerulli L. Retinal involvement in pigment dispersion syndrome. IntOphthalmol1996; 19: 375–378.

Sugar HS, Barbour FA. Pigmentary glaucoma; a rare clinical entity. Am J Ophthalmol. 1949; 32:90–92.

Campbell DG. Pigmentary dispersion and glaucoma. A new theory. Arch Ophthalmol. 1979; 97:1667–1672.

Karickhoff JR. Pigmentary dispersion syndrome and pigmentary glaucoma: a new mechanism concept, a new treatment, and a new technique. Ophthalmic Surg. 1992; 23:269–277.

Gillies WE. Pigmentary glaucoma: a clinical review of anterior segment pigment dispersal syndrome. Aust NZ J Ophthalmol 1985; 13: 325–328.

Siddiqui Y, Ten Hulzen RD, Cameron JD, Hodge DO, Johnson DH. What is the risk of developing pigmentary glaucoma from pigment dispersion syndrome? Am J Ophthalmol2003; 135: 794–799.

Tugal-Tutkun I, Araz B, Taskapili M, Akova YA, Yalniz-Akkaya Z, Berker N,Emre S, Gezer A. Bilateral Acute Depigmentation of the Iris: Report of 26 New Cases and Four-year Follow-up of Two Patients. Ophthalmology 2009; 116:1552–1557.

Tugal-Tutkun I, Onal S, Garip A, Taskapili M, KazokogluH,Kadayifcilar S,Kestelyn P.Bilateral Acute Iris Trans-illumination. Arch Ophthalmol 2011; 129:1312-1319.

Feibel RM, Perlmutter JC. Anisocoria in the pigmentary dispersion syndrome. Am J Ophthalmol. 1990; 110:657-660.

Feibel RM. Anisocoria in the pigmentary dispersion syndrome: further cases.J Glaucoma. 1993; 2:37-38.

Campbell DG. Pigmentary dispersion and glaucoma: a new theory. Arch Ophthalmol1979; 97: 1667–1672.

Sugar HS. Pigmentary glaucoma: a 25-year review. Am J Ophthalmol1966; 62: 499– 507.

Scheie HG, Cameron JD. Pigment dispersion syndrome: a clinical study. Br J Ophthalmol1981; 65: 264–269.

Prince AM, Ritch R. Clinical signs of the pseudoexfoliation syndrome. Ophthalmology 1986; 93: 803–807.

Wilensky JT, Buerk KM, Podos SM. Krukenberg’s spindles. Am J Ophthalmol1975; 79: 220–225.

Sugar S. Pigmentary glaucoma and the glaucoma associated with the exfoliation-pseudoexfoliation syndrome: update. Ophthalmology 1984; 91: 307–310.

Weseley P, Liebmann J, Walsh JB, Ritch R. Lattice degeneration of the retina and the pigment dispersion syndrome. Am JOphthalmol1992; 114: 539– 43.

Ritch R. A unification hypothesis of pigment dispersion syndrome. Trans Am OphthalmolSoc1996; 94: 381–409.

Farrar SM, Shields MB. Current concepts in pigmentary glaucoma. SurvOphthalmol1993; 37: 233–252.

Gandolfi SA, Vecchi M. Effect of a YAG laser iridotomy on intraocular pressure in pigment dispersion syndrome. Ophthalmology 1996; 103:1693–1695.

Reistad CE, Shields MB, Campbell DG, Ritch R, Wang JC, Wand M: American Glaucoma Society Pigmentary Glaucoma Iridotomy Study Group. The influence of peripheral iridotomy on the intraocular pressure course in patients with pigmentary glaucoma. J Glaucoma 2005; 14:255–259.