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Siddiqui What is risk of pigmentary glaucoma from pigment dispersion syndrome?
The overall estimated incidence of pigmentary glaucoma was 1.4 per 100,000
(95% CI; 0.9,1.9), which includes the 23 patients diagnosed at the initial examination and
the 9 who later converted (Figure 3).
Discussion
The risk of developing pigmentary glaucoma from pigment dispersion syndrome
is low but not insignificant: 10% at 5 years, increasing to15% by 15 years. The most
predictive factor for conversion was the IOP >21 mm Hg at initial diagnosis of pigment
dispersion. Each 1 mm Hg increase in IOP in pigment dispersion syndrome patients
increased the risk of conversion to pigmentary glaucoma 1.4 times (95% CI 1.2-1.6).
Based on this, pigment dispersion syndrome patients with IOP greater than 21 mm Hg
should be followed periodically for development of glaucoma. Age, refractive error, and
family history of glaucoma were not associated with an increased conversion risk. Also
of significance, 17% (23/136) of all patients had pigmentary glaucoma at the time of
initial diagnosis of pigment dispersion. Thus, the findings of pigment dispersion should
alert the clinician to look for glaucoma at the initial examination.
Pigment dispersion syndrome was found most commonly in patients between the
ages of 30 and 50 years, consistent with other reports.
2,4
Myopia was also associated
with pigment dispersion syndrome and pigmentary glaucoma, with a mean myopic
correction of -3.9 diopters in both pigment dispersion syndrome patients and pigmentary
glaucoma patients, again as reported by others.
2,3,10
Although pigment dispersion
syndrome was found to affect men and women in almost equal proportions, pigmentary
glaucoma was more common in men. It is interesting to note that women who developed
