September 26, 2012
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Pupil ruff atrophy associated with asymmetry in IOP, cup-to-disc ratio

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Asymmetric pupillary ruff changes correlated with asymmetry in IOP and cup-to-disc ratio, according to a study.

Pupillary ruff loss or thinning is commonly described as a consequence of pseudoexfoliation. The researchers proposed that pupil ruff atrophy may be a precursor of pseudoexfoliation or that pupil ruff atrophy changes may be an independent risk factor for elevated IOP and glaucoma.

The prospective study included 103 patients with a mean age of 64 years.

Pupil ruff atrophy grading, IOP, cup-to-disc ratio and presence of pseudoexfoliation material were evaluated.

The main outcome measure was the correlation between inter-eye pupil ruff atrophy grading differences and inter-eye IOP and cup-to-disc ratio differences.

Study results showed that the average amount of abnormal ruff was 9.5 clock hours and missing ruff was 5 clock hours. Inter-eye IOP asymmetry correlated with asymmetry of the amount of abnormal ruff (P = .034) and amount of missing ruff (P = .022).

Inter-eye cup-to-disc ratio asymmetry strongly correlated with asymmetry of the amount of missing ruff (P = .001) and trabecular meshwork pigmentation (P = .006).

Eyes with the most pupillary ruff loss were 25% more likely to have greater cup-to-disc ratio, the study authors said.