Pseudoexfoliation Syndrome

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Contents

Disease Entity

Exfoliation/Pseudoexfoliation syndrom is a systemic disease. It is most commonly noted in older individuals, typically over 50 years of age.


Disease

Exfoliation (pseudoexfoliation) Syndrome is characterized by the fibrillar deposits in the anterior segment of the eye. The depoits have been found on and in the subconjunctival tissue, pupillary margin, cilieary epithelium, lens epithelium, lens capsule, iris pigment epithelium, trabecular meshwork,cornea,zonules, orbital soft tissues, iris stroma and iris blood vessels. These deposits have also been found elsewhere in the body, including intrabdominally.

The disease may be bilateral by asymmetric.

It has been associated with myocardial infarction, cerebrovascular events and systemic hypertension.

Etiology

Etiology is unknown. It may be a type of basement membrane disorder.

Risk Factors

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General Pathology

The deposits are composed of elastic fibers (fibrillin and α-elastin)and noncollagenous basement membrane materials (laminin)which form fibrils. They are coated with the glycosaminoglycan hyaluroni acid.

Pathophysiology

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Primary prevention

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Diagnosis

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History

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Physical examination

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Signs

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Symptoms

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Clinical diagnosis

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Diagnostic procedures

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Laboratory test

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Differential diagnosis

LENS CAPSULE: True exfoliation

TRABECULAR MESHWORK HYPERPIGMENTATION/GLAUCOMA: Pigment dispersion,

IRIS TRANSILLUMINATION DEFECTS:

Management

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General treatment

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Medical therapy

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Medical follow up

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Surgery

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Surgical follow up

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Complications

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Prognosis

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Additional Resources

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References

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Original article contributed by: Alpa S. Patel, M.D.
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