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SM Jeng, RA Karger, DH Johnson, DO Hodge, J Burke, MS Good; Conversion rate of Pseudoexfoliation Syndrome to Pseudoexfoliation Glaucoma in a Population-based Study . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2947.
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Purpose: To determine the conversion rate of pseudoexfoliation syndrome (PEX) to pseudoexfoliation glaucoma (PEX-GL) in a population-based study. Methods: Using the Rochester Epidemiology Project database, we identified and reviewed the charts of all residents of Olmsted County, Minnesota newly diagnosed with PEX between 1976-1986. Patients diagnosed with PEX were followed until their last examination. Endpoints were treatment of ocular hypertension (TOHT) or the development of glaucoma (PEX-GL), defined as at least 2 of the following: intraocular pressure ≷ 21mmHg, glaucomatous optic nerve damage, or glaucomatous visual field defect. The probabilities for initiation of TOHT or conversion to PEX-GL were calculated by Kaplan-Meier estimates. Results: One hundred forty three eyes of 101 patients were newly diagnosed with PEX. Eighty-six eyes of 65 patients were started on treatment for ocular hypertension or developed glaucoma within 15 years of follow up. There were 50 females and 15 males with an average age of 76+/-10 years. The 5 year cumulative probability of PEX requiring treatment for ocular hypertension or converting to glaucoma was 57%(95% CI 47%-64%). At 10 and 15 years follow up, the cumulative probability of PEX requiring treatment for ocular hypertension or converting to glaucoma was identical at 64%(95% CI 54%-72%). Upon initial diagnosis of PEX, 27% of patients required treatment for ocular hypertension or were found to have glaucoma. Conclusion: In a geographically defined population of PEX patients, about one quarter required treatment for ocular hypertension or were found to have glaucoma upon presentation. An additional one third required treatment to control intraocular pressure or developed glaucoma over the next ten years. Patients with PEX have a 64% chance of requiring glaucoma treatment by 10 years.
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