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Siddiqui What is risk of pigmentary glaucoma from pigment dispersion syndrome?
of the meshwork and only one of the other two signs. The diagnosis would have been
missed in these patients if gonioscopy had not been performed.
The majority of patients were myopic (Figure 1); the mean myopic refractive
error was 3.9 ± 2.7 diopters (range: -0.1 to 12.0 diopters; 16 patients were > 6
diopters). The condition was most commonly diagnosed between the ages of 30-49, with
a mean age of 41 ± 12 years (n=113 patients; Figure 2). 58% of patients were male. A
positive family history for glaucoma in siblings, parents or grandparents, or aunts or
uncles was recorded in 21%; none of the family members were known to have pigment
dispersion syndrome. At initial diagnosis, the mean IOP of was 18.4 ± 4.1 mm Hg, and at
the last examination was 17.4
± 3.2 mm Hg (n=97). The range of follow-up times was 90
days to 22 years, with a mean of 8 ± 6 years (median: 6 years).
2) Probability of conversion: Of the 113 pigment dispersion syndrome patients
without glaucoma at the initial examination, 9 were placed on therapy for glaucoma over
the 24 year period. Of these, 7 had newly acquired glaucomatous damage (field defect:
56%, disc change: 45%). Two patients were placed on therapy for elevated IOP without
disc nor field damage. The duration from initial pigment dispersion syndrome diagnosis
to pigmentary glaucoma conversion ranged from 6 months to 15 years. At five years, the
Kaplan-Meier estimate of the probability of being placed on therapy was 10%, at 15
years: 15% (Figure 4).
3) Characteristics of patients converting to pigmentary glaucoma: The mean IOP
at the time of discovery of pigment dispersion syndrome was 24.0 ± 3.0 mm Hg in this
group, and at the initiation of therapy was 24.1
± 4.5 mm Hg. Of the patients converting,
