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Pigment dispersion plus high IOP equals higher risk for pigmentary glaucoma
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The most significant risk factor for conversion from pigment dispersion syndrome to pigmentary glaucoma was an intraocular pressure greater than 21 mm Hg, according to a long-term study. Additionally, younger age, male sex and myopia were associated with increased risk of converting to pigmentary glaucoma from pigment dispersion syndrome.
Yasmin Siddiqui, MD, and colleagues at the Mayo Clinic reviewed all cases of pigment dispersion syndrome or pigmentary glaucoma that had been newly diagnosed between 1976 and 1999 in Olmsted County, Minn. Diagnosis with pigment dispersion syndrome required two of three signs: midperipheral radial iris transillumination defects; Krukenberg spindle or heavy trabecular meshwork pigmentation. Criteria for diagnosis with pigmentary glaucoma were pigment dispersion syndrome and an additional two of three findings: IOP greater than 21 mm Hg, optic nerve damage or visual field loss.
Over the course of 24 years, 113 patients were diagnosed with pigment dispersion syndrome. Of these patients, nine developed pigmentary glaucoma or elevated IOP that required therapy. At 5-year follow-up, the probability of converting to pigmentary glaucoma was 10%. This increased to 15% at 10-year follow-up. An additional 23 patients were diagnosed with pigmentary glaucoma at the initial exam.
The mean age at diagnosis of pigmentary glaucoma was 42. Males accounted for 78% of those diagnosed with the disease. In contrast, among those with pigment dispersion syndrome, 58% were male.
“The most significant risk factor for conversion to pigmentary glaucoma was an IOP greater than 21 mm Hg at initial examination, whereas age, refractive error and family history of glaucoma were not correlated with conversion,” the authors reported in the American Journal of Ophthalmology.