Owing to pseudoexfoliation glaucoma’s prevalence and severity, gonioscopy should be performed to assess for pigment deposition and a Sampaolesi’s line. Sampaolesi line is a sign which may be observed during a clinical eye examination. During gonioscopy if an abundance of brown pigment is seen at or anterior. The Glaucomas. Volume II – Open Angle Glaucoma and Angle Closure Glaucoma. Authors; (view affiliations). Roberto Sampaolesi; Juan Roberto Sampaolesi.

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Reducing the release of pigment may slow the progression of these diseases and may even lead to a clearing of the trabecular meshwork. Create account Log in. Future Directions Current research on pseudoexfoliation syndrome is centered on genetic factors that predispose certain populations to its development.

: pseudoexfoliation glaucoma

Estimated incidence of pseudoexfoliation syndrome and pseudoexfoliation glaucoma in Olmsted County, Minnesota. Pupil dilatation is often poor. Other risk factors associated with this disorder include living at higher altitudes or in northern latitudes, and disproportionately high exposure to ultraviolet light.

In cases of PXF with secondary angle closure due to zonular laxity, the key to distinguishing it from PACG is the asymmetry in anterior chamber depth, as well as the presence of pseudoexfoliative material.

Please see the section Laser Trabeculoplasty: Cataract surgery does not reduce glaucoma risk. Glaucoma is rare with true exfoliation or capsular delamination. Therefore annual assessment is required. Unfortunately, they are no longer manufactured, which has created a serious problem for our younger patients. It has been shown that specific mutations of the LOXL1 glaucomaa are strongly associated with the development of PXF and secondary glaucoma.


Optical coherence tomography OCT allows the retinal nerve fiber layer to be assessed aampaolesi any changes. Retro-illumination of lens showing the bullseye galucoma on the anterior lens capsule. Because not all patients with pigment dispersion syndrome develop elevated IOP, and because the iridotomy procedure itself results in a significant release of pigment, we do not currently advocate treating normotensive eyes.

Pseudoexfoliative Glaucoma – EyeWiki

Pigment liberation test in open-angle glaucoma. We have seen a patient with exfoliative glaucoma who suffered a central retinal vein occlusion and an IOP spike to 55 mm Hg after pupillary dilation.

Incomplete elimination of exercise-induced pigment dispersion by laser iridotomy in pigment dispersion syndrome. Gonioscopy most commonly reveals an open anterior chamber drainage angle. In pseudophakic and aphakic eyes, it may be deposited on intraocular lens and the vitreous face, respectively.

Improvement of pigmentary glaucoma and healing of transillumination defects with miotic therapy. Effects of jogging exercise on patients with the pigment dispersion syndrome and pigmentary glaucoma. Because the pressure rise OS was gradual, patients may not experience pain and severe cornea edema that is seen with sudden angle closure glaucoma.

In amyloidosis, amyloid material that resembles pseudoexfoliation material can deposit in a similar distribution and can even lead to glaucoma. In addition, pseudoexfoliation material has been identified on the iris surface, corneal endothelium and zonules. However, amyloidosis is a systemic disease affecting the kidney, liver and spleen, leading also to recognizable nonocular symptoms. Several treatment options exist for pseudoexfoliation glaucoma, and your management approach should be tailored to each patient.


However, the duration of IOP lowering is limited with more than half of patients failing after 5 years.

Ocular echometry in the diagnosis of congenital glaucoma.

By preventing the liberation of pigment from the iris, laser iridotomy should allow the trabecular meshwork to clear itself and avoid further pigmentary deposition. Most Viewed content is not available. There is also an increased risk of complications due to poor pupil dilatation and zonular weakness.

Of note, once laser trabeculoplasty starts to wear off, patients with pseudoexfoliation glaucoma tend to demonstrate a more rapid IOP increase than POAG patients. Submit manuscripts to eyenet aao. However, in pigmentary glaucoma the defects are slitlike in a radial distribution of the midperipheral iris, whereas in pseudoexfoliation glaucoma the defects are more patchy and closer to the pupillary margin. Poor pupillary response to dilation is a subtle finding that glsucoma observed frequently in patients with pseudoexfoliation syndrome and resultant glaucoma.

The lysyl oxidase-like protein 1 LOXL1 gene is important for elastin metabolism. Glahcoma surgery is often required in patients with PXF due to the increased incidence. Current Issue Archive Polls News. The examination and treatment of these patients is similar to that described earlier for exfoliation glaucma.

Subscriptions Advertising About Contact Privacy. This patient was treated with topical anti-glaucoma medications and the IOP was controlled in the 30s OS.