Abstract
Purpose :
Pseudoexfoliation syndrome (PXS) presents unique challenges in the management and treatment of many associated ocular pathologies, including glaucoma. Glaucoma is the second leading cause of blindness among African Americans, and data suggests that Ethiopians may also be at an increased risk of developing pseudoexfoliative glaucoma. The following is an ongoing case series of Ethiopian patients seen at the Howard University Hospital Ophthalmology clinic with PXS.
Methods :
We are analyzing the health records of Ethiopian PXS patients at Howard University Hospital from 2016 to 2018. Collected data includes demographic information, medications, ocular surgical history, initial and final visual acuity (VA) and intraocular pressure (IOP) measurements. We categorized VA ≥ 20/40 as mild visual loss (MVL), VA between 20/40 and 20/200 as moderate visual loss (MdVL), and VA < 20/200 as severe visual loss (SVL).
Results :
Of 9 PXS patients, 5 were males aged between 43 and 76 and 4 were females aged between 66 and 91. Overall mean age was 69 (43-91). Of the 18 eyes, 17 eyes (94.4%) had PXS. Of 17 eyes at baseline, 7 (41.2%) had MVL, 6 (35.3%) had MdVL, and 4 (23.5%) had SVL. At final visit, 6 eyes were lost to follow-up leaving a total of 11 eyes, 4 (36.4%) had MVL, 5 (45.5%) had MdVL, and 2 (18.2%) had SVL. 11 eyes with PXS (64.7%) were diagnosed with open-angle glaucoma. Mean initial IOP was 18.6 mmHg (10-49 mmHg) and mean final IOP was 12.2 mmHg (6-21 mmHg). Maximum IOP (T-max) was 49 mmHg at initial visit, and T-max was 21 mmHg at final visit.
Nine of 17 eyes with PXS (52.9%) were prescribed topical glaucoma medications. Of those 9 eyes, 1 (11.1%) was managed on 4 drops, 6 (66.6%) were managed on between 2 and 3 drops, and 2 (22.2%) were managed on 1 drop. Of 17 eyes with PXS, 9 (52.9%) had combined cataract and glaucoma surgeries (7 trabeculectomies and 2 minimally-invasive glaucoma surgeries), 4 (23.5%) had only cataract surgery, 2 (11.8%) had only glaucoma surgery (trabeculectomies), and 2 (11.8%) had no ocular surgery.
Conclusions :
The Washington, D.C. area is home to the second largest population of Ethiopians outside of Ethiopia. This is the first study to explore the prevalence of this ocular pathology in this patient subset. Overall, VA and IOP improved or remained stable in our case series. Approximately, half of our subjects were managed with glaucoma medications and most of them underwent glaucoma surgery.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.