Diverse Types of Glaucoma in Patients with Pseudoexfoliation Syndrome: Normal Pressure Glaucoma

Ji Young Seo; In Won Park; Yun Suk Chung

doi:10.3341/jkos.2011.52.12.1455

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Seo, Park, and Chung: Diverse Types of Glaucoma in Patients with Pseudoexfoliation Syndrome: Normal Pressure Glaucoma

Original Article

J Korean Ophthalmol Soc 2011;52(12):1455-1460.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.12.1455

Diverse Types of Glaucoma in Patients with Pseudoexfoliation Syndrome: Normal Pressure Glaucoma

Ji Young Seo, MD, In Won Park, MD, Yun Suk Chung, MD

Department of Ophthalmology, Hallym University College of Medicine, Anyang, Korea

Address reprint requests to Yun Suk Chung, MD Department of Ophthalmology, Hallym University Sacred Heart Hospital #896 Pyeongchon-dong, Dongan-gu, Anyang 431-070, Korea Tel: 82-31-380-3834, Fax: 82-31-380-3837, E-mail: eyechung90@hanmail.net

Received 13 August 201019 May 2011 Accepted 12 October 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the types of glaucoma in patients with pseudoexfoliation syndrome (PXS) and analyze the glaucomatous changes in patients with normal intraocular pressure (IOP).

Methods

A retrospective chart analysis of patients diagnosed with PXS was performed. The types of glaucoma were classified based on the IOP, optic disc examination, visual field test results, and optical coherence tomography (OCT) results. Other than those with pseudoexfoliative glaucoma (PXG), the normal IOP patients with PXS were divided into glaucomatous and nonglaucomatous groups. Later, the glaucomatous group was clinically compared to the nonglaucomatous group.

Results

The records of 40 patients with PXS were evaluated. Among the 48 PXS eyes, high pressure glaucoma was found in 21 eyes (43.75%), low pressure glaucoma in 5 eyes (10.42%), and non-glaucoma in 19 eyes (39.58%). However, in the 32 fellow eyes without PXS, 2 eyes (6.25%), 8 eyes (25%), and 20 eyes (62.5%) showed the above diseases, respectively. In result, PXS affected the glaucomatous change (odds ratio = 2.544, p = 0.045). By contrast, in PXS patients with normal IOP, PXS did not affect the glaucomatous change (p = 0.519).

Conclusions

Diverse types of glaucoma including low pressure glaucoma may exist in patients with PXS. Considering the possibility of low pressure glaucoma in patients with PXS is necessary.

Keywords: Low pressure glaucoma, Normal intraocular pressure, Pseudoexfoliation syndrome

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Figure 1.

Types of glaucoma in patients with pseudoexfoliation syndrome. PXS =pseudoexfoliation syndrome; OAG = open angle glaucoma; ACG = angle closure glaucoma; LPG = low pressure glaucoma; OHT = ocular hypertension.

Table 1.

The characteristics of patients with pseudoexfoliation syndrome

Patient (eye)	40 (80)
Age (mean ± SD, yr)	72.6 ± 8.0
Sex (M:F)	16:24
Pseudoexfoliation (eye)	48
Bilateral PXS (patient, %)	8 (20)
Mean IOP (mean ± SD, mm Hg)	20.3 ± 9.85
Central corneal thickness	546.4 ± 28.8
(mean ± SD, μ m)
Diabetes mellitus	8 (20%)
Hypertension	19 (47.5%)
Angina	1 (2.5%)
Stroke	2 (5%)

PXS = pseudoexfoliation syndrome; IOP = intraocular pressure.

Table 2.

Comparison of the characteristics of normotensive patients between groups with and without glaucoma

	Glaucomatous	Non-glaucomatous	p-value
Number of eyes	13	39
Age (mean ± SD, yr)^∗	72.2 ± 11.2	73.4 ± 9.7	p = 0.742^†
Sex (M:F)^∗	4:6	12:15	p = 1.000^‡
Pseudoexfoliation (%)	38.5	48.7	p = 0.519^§
Mean IOP (mean ± SD, mm Hg)	15.9 ± 2.0	13.8 ± 2.8	p < 0.05^†

IOP = intraocular pressure.

^∗ Statistical analysis was performed except bilateral glaucomatous group (n = 3) or bilateral nonglaucomatous group (n = 12)

^† Student t-test;

^‡ Fisher's exact test

^§ Chi-square test.

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