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International Ophthalmology
Published in: International Ophthalmology 7/2019

01-07-2019 | Perspectives or Expert Opinions

Pigment dispersion syndrome and pigmentary glaucoma: a review and update

Authors: Gianluca Scuderi, Maria Teresa Contestabile, Luca Scuderi, Aloisa Librando, Vito Fenicia, Siavash Rahimi

Published in: International Ophthalmology | Issue 7/2019

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Abstract

Introduction

Pigment dispersion syndrome (PDS) is a condition where anomalous iridozonular contact leads to pigment dispersion throughout the anterior segment and the released pigment is abnormally deposited on various ocular structures.

Clinical presentation

The clinical presentation of PDS is defined by the presence of pigmented cells on the corneal endothelium, an increase of pigmentation of the trabecular meshwork, and mid-periphery transillumination defects of the iris. This syndrome, more common in myopes, is usually bilateral and can be associated with ocular hypertension or glaucoma. Secondary open-angle pigmentary glaucoma (PG) can develop due to reduction of the outflow of aqueous humour and consequent increase in intraocular pressure leading to glaucomatous optic neuropathy. Diagnosis of PG is commonly between 40 and 50 years of age, occurring more frequently in men. The advent of ultrasound biomicroscopy and anterior segment optical coherence tomography has contributed to enhancing our knowledge on the condition. Typical alterations of the anterior segment are the posterior insertion of the iris and iris concavity. Treatment of PG should be initiated early to hinder disease progression, glaucomatous damage, and vision loss. Management is based on medical therapy, laser iridotomy, selective laser trabeculoplasty, and filtration procedures.

Conclusions

The differential diagnosis of PDS with other disorders can be challenging and awareness of the condition together with meticulous ophthalmologic examination allows early diagnosis followed by appropriate management strategies. The present review is a comprehensive report on the clinical characteristics, pathogenesis, current management, and status quo of PDS and PG.
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Metadata
Title
Pigment dispersion syndrome and pigmentary glaucoma: a review and update
Authors
Gianluca Scuderi
Maria Teresa Contestabile
Luca Scuderi
Aloisa Librando
Vito Fenicia
Siavash Rahimi
Publication date
01-07-2019
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 7/2019
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-018-0938-7

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