Global Ophthalmology and Glaucoma Conference

Purpose: To determine the frequency of occurrence of pigmentary Glaucoma in patients with Pigment Dispersion Syndrome (PDS).

 

Material & Methods: This prospective follow up study was conducted from August 2001 to March 2015 at Ophthalmology Department Chandka Medical College, Larkana, Pakistan. Patients presenting with Krukenberg’s spindle on the endothelial side of cornea and pigmentation of angle of anterior chamber seen on slit lamp examination and gonioscopy were considered as cases of PDS. Patients with presence of secondary pigment dispersion associated with causes like, pseudoexfoliation, iris cyst, nevus, malignant melanoma, intraocular inflammation, intraocular surgery, ocular trauma and irradiation were excluded from the study. Slit lamp examination, Applanation Tonometry, Gonioscopy, Fundoscopy, Automated Perimetry and Refraction was performed on every case. SPSS version 20 was used for data entry and analysis.

 

Results: 72 cases of Pigment Dispersion Syndrome according to the inclusion criteria were included in the study, amongst them 63 (87.50%) were males and 9 (12.50%) were females. Mean age ± standard deviation of patients was 35.00±6.54 years and age range was 24 to 46 years. 47 (65.28%) patients had an IOP in the range of 10-14 mmHg, 22 (30.56%) patients had an IOP in the range of 15-18 mmHg and 3 (4.17%) patients developed an IOP of greater than 19 mmHg. Fundoscopy showed myopic degeneration in 49 (68.06%) patients and optic disc cupping in 3 (4.17%) patients. 4 (5.56%) patients had refractive error between +1D to +3D, 9 (12.50%) patients had refractive error between -1D to -4D, 21 (29.17%) patients had refractive error between -5 D to -8 D and 38 (52.78%) patients had refractive error between -9 D to -12 D. Our study showed that 1.64% patients having PDS developed glaucoma at 5 years of follow up and 7.32% patients developed glaucoma at 14 years of follow up. 

 

Conclusion: On the basis of this study we conclude that early onset primary open angle glaucoma associated with Pigment Dispersion Syndrome or Juvenile glaucoma associated with PDS might have been mistaken as Pigmentary Glaucoma in Pakistani patients (black population) and a distinct entity in the form of Pigmentary Glaucoma may be non-existent in blacks.