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Lance K. Bergstrom, John C. Cawley, Corey L. Becker; Risk of AAA with Pseudoexfoliation Syndrome. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3827.
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Pseudoexfoliation Syndrome (PEX) is an age-related exfoliative elastic microfibrillopathy characterized by extensive production and accumulation of pseudoexfoliative material in the anterior chamber of the eye, and throughout the body.Previous studies have reported conflicting findings between PEX and abdominal aortic aneurysms (AAA).The aim of this study was to investigate the association between pseudoexfoliation syndrome and abdominal aortic aneurysms.
A chart review of 450 patients was conducted. 225 of the patients were randomly selected from the population that had an AAA diagnosed within the last three years. Additionally to have an age-matched control group 225 patients who underwent a routine screening colonoscopy sometime in the previous 3 years were also randomly selected, as it was felt the colonoscopy group would appropriately reflect the prevalence of PEX within the general population.Data was collected on patient Age, Gender, Body Mass Index, Tobacco use, Heart Disease, Hypertension, Diabetes, COPD, Dyslipidemia, Use of Doxycyline (Vibramycin) to prevent AAA, Cause of Death, Size of AAA, and Presence of Ocular PEX.Descriptive statistics and a univariate analysis of data were performed with SAS software v9.1.3 (SAS Institute, Cary, NC 25513, USA).
Of the 225 patients included in the Colonoscopy/Control group 03 (1%) had diagnosed ocular PEX and of the 225 patient in the AAA/test group 24 (11%) had diagnosed PEX. The prevalence of PEX was statistically significant with a p-value of 0.0001. Additionally it was found that the AAA group was significantly more likely to be male, and older in comparison to the colonoscopy group.As previously documented as risk factors for having an AAA6; Older age, Male sex, Tobacco use, Heart Disease, Hypertension, and Chronic Obstructive Pulmonary Disease, the prevalence of each were found to be significantly increased in the AAA group.
This study appears to support the argument that there is an association between ocular PEX and AAAs. This would further support the statements made by Schumacher et al. in his Lancet publication. Furthermore the postmortem histological studies done by Schumacher and Streeten7 show aggregates of proteinaceous material morphologically similar to pseudoexfoliative material within the walls of the abdominal aorta adjacent to areas of marked elastosis. This supports a histopathophysiologic mechanism of systemic PEX leading to increased susceptibility of forming an AAA.This study’s significance is paramount. The data would suggest that ocular Pseudoexfoliation Syndrome be added to the list of Hypercholesterolemia, Dyslipidemia, Hypertension, Male sex, Tobacco use and Family history of AAA as risk factors for an abdominal aortic aneurysm.
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