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Siddiqui What is risk of pigmentary glaucoma from pigment dispersion syndrome?
pigmentary glaucoma in our study did so approximately a decade later than men. The
reason for later occurrence in women is unknown.
2,10
The conversion rate found in this community-based study was lower than that
reported in glaucoma subspecialty practices (Table).
5-7
Glaucoma specialists are often
referred patients with suspicious discs or fields, or borderline high intraocular pressures,
and these "at risk" patients probably account for the higher conversion rates in these
studies. In addition, the higher conversion rates soon after diagnosis of pigment
dispersion syndrome noted by others may simply reflect the physicians waiting several
months to repeat borderline abnormal visual field tests or to recheck elevated intraocular
pressures. This would not represent a "biologic effect" of a rapidly worsening condition,
but rather a delay in diagnosis.
The limitations of our study were those to be expected of a retrospective study.
Patient follow-up was incomplete, although 80% (109/136) had eye examinations within
the final 5 years of the end of the study. The remaining patients were contacted but
declined to return for examination. Second, as a community-based study, patients were
seen by a variety of ophthalmologists and optometrists and not just glaucoma specialists.
Examination techniques, interpretation of optic discs, level of intraocular pressure
elevation requiring treatment and recording of data varied among physicians. For
example, recording of optic nerve condition included photography (15% of cases),
drawings (20%), and written descriptions (65%). Similarly, not all patients with pigment
dispersion syndrome and normal discs and intraocular pressures had visual field
examinations.
