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Siddiqui What is risk of pigmentary glaucoma from pigment dispersion syndrome?
5) Clinical course of pigmentary glaucoma: Visual field progression was noted in
44% of all pigmentary glaucoma cases over the follow-up period. During follow-up the
probability of surgical intervention for patients with pigmentary glaucoma was 18% for
laser trabeculoplasty and 10% for filtration surgery by 10 years; none of the PDS only
patients who did not convert had laser or surgery. For all pigmentary glaucoma patients,
the IOP on treatment at the last examination was 18.0
± 4.0 mm Hg.
Two patients developed legal blindness. One patient was diagnosed with
pigmentary glaucoma at age 45, with an IOP of 52 and significant field defects. Despite a
trabeculectomy, he became blind in one eye after 21 years (double arcuate scotomas and
loss of central acuity). The second patient was 61 years old when pigmentary glaucoma
was diagnosed, and developed bilateral blindness (double arcuate scotomas but
preservation of central acuity OU) in one eye at 10 years and in the fellow eye at 13
years.
Estimated annual incidence of PDS and pigmentary glaucoma
The estimated incidence of pigment dispersion syndrome was 4.8 per 100,000
(95% CI: 3.9, 5.7), and was higher in men (p=0.04; Figure 3). Patients were diagnosed
with PDS between the ages of 30-49 at a significantly higher proportion than any other
age group. After adjusting for multiple comparisons the 30-39 and 40-49 age groups were
significantly different from the 0-29 and 70 and over age groups (p<0.05). The 0-29 age
group was also significantly different from the 60-69 age group (p<0.05). No other
groups were significantly different.
