Abstract
Purpose::
To investigate demographic and phenotypic eye characteristics of patients with pigment dispersion syndrome (PDS) or pigmentary glaucoma (PG) compared to normal subjects.
Methods::
102 eyes of 102 patients with PDS-PG and 56 eyes of 56 healthy age and refraction matched controls have been enrolled in this cross sectional observational clinical study. All subjects underwent keratometry, biomicroscopy, ophthalmoscopy, gonioscopy, corneal thickness (CCT) measurement and A-scan biometry. Trabecular meshwork pigmentation (TMP), Krukenberg spindle (KS) and iris concavity were subjectively graded on four point scales. Axial length (AxL), anterior chamber depth, lens thickness, lens position and lens/axial length ratio were calculated from A-scan measurements. Mann-Whitney, Spearman’s Rho and Chi-squared tests were used to analyze data.
Results::
Age and spherical equivalent were similar among PDS-PG patients and control subjects (48.4±15.3 vs 47.8±13.1, p=0.09 and -3.45±3.50D vs -3.25±3.06D, p=0.34). CCT (p=0.14), average keratometry (p=0,21), lens thickness (p=0,84), lens position (p=0,55), AxL (p=0.12) and lens/AxL ratio (p=0,13) were similar between groups. AC was significantly deeper in PDS-PG patients compared to controls (3.89±0.37mm vs 3.63±0.29mm, p=0,010). Lens thickness was found significantly related to age in both groups (PDS group r=0.63, p=0,0001, control group r=0.37, p=0,004). Iris profile was found significantly more concave in PDS-PG compared to control subjects (p<0.001). In the PDS-PG group significant correlations were found between iris concavity and AxL (r=0.32, p=0.01), ACD (r=0.31, p=0.03), and Lens/AxL ratio (r=-0.28, p=0.06). Grading of KS was found to correlate with grading of TMP (r=0.4, p<0.01) and both gradings were found not related to age (r=-0.07, p=0.4 and r=0.13, p=0.19).
Conclusions::
Eyes with PDS-PG have a deeper ACD compared to normal age and refraction matched eyes. Lens thickness, keratometry and Lens thickness/AxL ratio are similar in PDS-PG patients and control subjects. TMP and KS are not related to age. PDS-PG subjects have a higher incidence and severity of iris concavity which does not correlate with the severity of TMP and KS suggesting the presence of other concomitant factors influencing the extent of iris pigment release.
Keywords: trabecular meshwork • iris