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Ruojin Ren, Jingwen Ding, Ningli Wang, Gustavo V de Moraes, Jost B Jonas, Christopher Teng, Robert Ritch; Clinical Signs and Characteristics of Exfoliation syndrome (XFS) and Exfoliative Glaucoma (XFG) in Northern China. Invest. Ophthalmol. Vis. Sci. 2011;52(14):245.
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The prevalence of XFS and XFG vary considerably among different populations.This systemic condition is rare among individuals of Chinese ethnicity and the literature is scanty on this topic.Ye et alanalyzed the clinical features of 11 patients with XFS in southern China. We investigated the prevalence and clinical characteristics of XFS/XFG in northern China.
A retrospective medical chart review was conducted in Beijing Tongren Hospital. Using diagnosis codes, all patients with XFS/XFG were included in the study. XFS was diagnosed if the patient had exfoliation material on the pupillary margin or anterior lens capsule. XFG was defined as presence of XFS and the following features: (1) glaucomatous changes of the optic disc, defined as cup-to-disc ratio >0.7 in either eye, an asymmetric cup to disc ratio of >0.2 or notching of the disc rim; and (2) characteristic glaucomatous visual field loss; and/or (3) IOP ≥22 mmHg in either eye.
From 73,976 inpatient records, 45 patients with XFS/XFG were identified; mean age was 72.1±8.1 yrs (range, 47- 85), with 27 (60%) males. These patients comprised 4.16% of the total number of glaucoma inpatients evaluated. Of the 45 patients, 9 had XFS, mean age 75.9±6.8 yr (range, 67-85) and 36 had XFG, mean age 71.1±8.2 yr (range, 47-84). The average intraocular pressure (IOP) at initial diagnosis was 19.97±6.6 mmHg (range, 8-49 mmHg). 30 of 45 (66.7%) patients had bilateral XFS/XFG, but the extent of optic nerve damage (55%) or visual field loss (31%) was asymmetric. Presence of exfoliation material (XFM) on the pupil rim (60%) and anterior lens surface (58%) were the most common features. 12 eyes (13%) were reported to have iris abnormalities (pupillary ruff defects or peripupillary atrophy) on slit-lamp examination. Flecks of XFM were seen on the posterior trabecular meshwork during gonioscopy (7/29 patients, 24%) and 25 eyes (28%) had narrow angles.
This is the largest report on the prevalence and characteristics of XFG/XFS in ethnic Chinese patients.
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