Abstract
In 1964 we treated a 42-year-old woman diagnosed to have classical bilateral pigment dispersion syndrome combined with an intraocular pressure (IOP) of up to 28 mmHg in both eyes. The patient now has a daughter, also with pigment dispersion syndrome. Miotic treatment brought the IOPs to normal, and 8 years later when the disease was in the inactive phase all treatment could be discontinued. At the age of 67 years, exfoliation deposits became visible in the right eye only, but the IOPs were still below 21 mmHg. Four years later, the pressure of the right eye rose to 31 mmHg. During the next few years all available IOP-lowering medications and laser trabeculoplasty failed, and finally trabeculectomy had to be performed to keep the pressure of the right eye under control and to halt visual field changes, which had already appeared. This case illustrates that development of exfoliation syndrome may take place irrespective of pigment dispersion, and that their simultaneous occurrence may lead to an IOP rise that is resistant to medical therapy and laser trabeculoplasty. It additionally provides further clues to the pathogenesis of capsular glaucoma.
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Sugar S . Pigmentary glaucoma and the glaucoma associated with the exfoliation-pseudoexfoliation syndrome: update. Ophthalmology 1984;91:307–10.
Layden WE, Ritch R, King DG, Teekhasaenee C . Combined exfoliation and pigment dispersion syndrome. Am J Ophthalmol 1990;109:530–4.
Ritch R, Leibmann JM . Prevalence of pigment dispersion syndrome in a population undergoing glaucoma screening. Am J Ophthalmol 1993;115:707–10.
Krause U, Alanko HI, Kärnä J, Miettinen R, Larmi T, Jaanio E, et al. Prevalence of exfoliation syndrome in Finland. Acta Ophthalmol (Copenh) Suppl 1988;184:120–2.
Tarkkanen A . Pseudoexfoliation of the lens capsule: a clinical study of 418 patients with special reference to glaucoma, cataract and changes of the vitreous. Acta Ophthalmol (Copenh) Suppl 1962;71.
Setälä K . Response of human corneal endothelial cells to increased intraocular pressure. Acta Ophthalmol (Copenh) Suppl 1989;144.
Knorr HL, Junemann A, Händel A, Naumann GOH . Morphometrische und qualitative Veränderungen des Hornhautendothels bei Pseudoexfoliationssyndrom. Fortschr Ophthalmol 1991;88:786–9.
Seitz B, Mueller EE, Langenbucher A, Kus MM, Naumann GOH . Endothelial keratopathy in pseudoexfoliation syndrome: quantitative and qualitative morphometry using automated video image analysis. Klin Monatsbl Augenheilkd 1995;207:167–75.
Kohno T, Tetsumoto K, Okubo K . Pigment dispersion score and corneal endothelial damage in exfoliation syndrome. Jpn J Clin Ophthalmol 1993;47:697–700.
Tarkkanen A, Horsmanheimo A . Topical corticosteroids and non-glaucomatous pseudoexfoliation. Acta Ophthalmol (Copenh) 1966;44:323–33.
Gillies WE . Corticosteroid induced hypertension in pseudoexfoliation of the lens capsule. Am J Ophthalmol 1970;70:90–5.
Pohjola S, Horsmanheimo A . Topically applied corticosteroids in glaucoma capsulare. Acta Ophthalmol (Copenh) 1971;85:150–3.
Kivelä T, Hietanen J, Uusitalo M . An autopsy analysis of clinically unilateral exfoliation syndrome. Invest Ophthalmol Vis Sci 1997;38:2008–15.
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Tarkkanen, A., Kivelä, T. Unilateral capsular glaucoma after long-standing bilateral pigmentary glaucoma. Eye 13, 212–214 (1999). https://doi.org/10.1038/eye.1999.53
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DOI: https://doi.org/10.1038/eye.1999.53
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