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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There is also an increased risk of complications due to poor pupil dilatation and zonular weakness.
Decreased pupillary dilation, along with weakened zonular fibers and synechiae between the iris and peripheral anterior lens capsule, make the cataract surgery technically difficult. Not reviewed add Contributing Editors: Pseudoexfoliation glaucoma tends to follow an unpredictable course, as it can be relatively benign or progress rapidly to advanced optic nerve damage.
Sign in to access your subscriptions Sign in to your personal account. Write a Pearls article! Pseudoexfoliation syndrome occurs in all areas of the world.
Preclinical diagnosis of pseudoexfoliation syndrome. 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. Create a free personal account to access your subscriptions, sign saampaolesi for alerts, and more.
Reducing the Release of Pigment
: pseudoexfoliation glaucoma
Rarely, there is an acute rise in IOP which samppaolesi cause symptoms of ocular pain, blurring of vision and seeing haloes. A slit-lamp exam with IOP measurement can expose many of the findings in pseudoexfoliation glaucoma. The visual potential OS was low with only a remnant of vision in the temporal field, and the patient wanted topical medications before considering cyclodestruction of the ciliary body.
The release of pigment into the anterior chamber is common and profuse after pupillary dilation in patients with exfoliation syndrome.
Several treatment options exist for pseudoexfoliation glaucoma, and your management approach should be tailored to each patient. Poor pupillary response to dilation is a subtle finding that is observed frequently in patients with pseudoexfoliation syndrome and resultant glaucoma.
Excessive pigment liberation seen in these eyes may be the result of fundamental defect in the iris or may be liberated from the iris as a result of rubbing of iris pigment epithelium against the rough lens capsule. However, in pigmentary glauclma 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.
Laser trabeculoplasty has been reported to be particularly effective in PXF glaucoma, due to the relatively pigmented angles. Sign in to save your search Sign in to your personal account. Doan A, Kwon YH: It is important to note that not every individual with pseudoexfoliation syndrome will develop pseudoexfoliation glaucoma. The iris in pigmentary glaucoma tends to have a concave configuration peripherally, which is another distinguishing feature.
Flourescein angiography and ultrastructural studies have shown hypoxia of the the iris, and hypoperfusion may be a sampaoldsi in development of exfoliation syndrome. The aim is to prevent or slow down further glaucomatous optic nerve damage. Sampaolesi R, Caruso R.
RegeneRx Biopharmaceuticals announced the outcome of discussions between its U. Traditional IOP-lowering medications are sampaoleei effective in pseudoexfoliation glaucoma than in POAG, but they are used frequently as first-line therapy. Create a free personal account to download free article PDFs, sign up for alerts, customize your interests, and more.
Miotic drops may exacerbate angle closure secondary to PXF.
Pilocarpine drops are poorly tolerated, however, because of accommodative spasm and induced myopia in younger patients.