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Siddiqui What is risk of pigmentary glaucoma from pigment dispersion syndrome?
Introduction
Pigmentary glaucoma characteristically develops in young myopic patients with
pigment dispersion syndrome.
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Pigment dispersion syndrome is characterized by
melanin pigment liberation from the iris pigment epithelium because of mechanical
disruption by lens zonules.
1,2
The released melanin pigment is carried by aqueous
convection currents into the anterior chamber where it is deposited on anterior segment
structures, including the corneal endothelium and the trabecular meshwork.
Accumulation of pigment in the meshwork may lead to increased resistance to aqueous
humor outflow, resulting in the development of glaucoma.
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Knowing the conversion rate from pigment dispersion syndrome to actual
glaucoma is essential in planning ophthalmic care. Three studies have examined the
conversion rate for the development of pigmentary glaucoma from pigment dispersion
syndrome. Results have varied, with conversion rates ranging from 35% at 17 years in
one study to as high as 50% at 4 years in another study.
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This variability may exist
because the studies were performed in glaucoma specialty practices, analyzing referred
patients. Knowledge of the conversion rate and risk factors for conversion in a general
population would allow the physician to recommend appropriate examination intervals
for pigment dispersion syndrome patients.
This study determined the conversion rate from pigment dispersion syndrome to
pigmentary glaucoma in a general population, with follow-up time of up to 22 years. We
also analyzed risk factors that would predict conversion to pigmentary glaucoma.
