Rao Aparna, Padhy Debananda, Sahay Prity, Pradhan Amiya, Sarangi Sarada, Das Gopinath, Raj Niranjan
Glaucoma Service, LV Prasad Eye Institute, Patia, Bhubaneswar, Odisha, India.
PLoS One. 2017 Oct 27;12(10):e0185373. doi: 10.1371/journal.pone.0185373. eCollection 2017.
To evaluate different clinical variants of pseudoexfoliation syndrome and their risk of developing ocular hypertension (OHT) or glaucoma (PXG).
Cross sectional hospital based study.
All patients seen at glaucoma services of a tertiary eye care center in east India.
Electronic medical records search of hospital database including consecutive new and old cases seen during April 2013 to March 2015 was done to retrieve case sensitive words including pseudoexfoliation, PXF, PEX, PXG and pseudoexfoliative glaucoma over any part of the clinical electronic sheet of the patient. All demographic and clinical details including laterality, the pattern of deposits, need for medicines and disc damage at presentation was compared in eyes with radial pigmentary, classical or combined forms of PXF phenotypes.
Of 110313 PXF patients seen during the period of 2013-2015, a total of 2297 eyes of 1150 PXF patients were identified including 525 unilateral PXF (meaning a total of 1775 PXF eyes with 625 patients having bilateral disease, n = 1250 eyes, other clinically normal eye, n = 522) at presentation. Of 525 unilateral PXF eyes, 105 had OHT and 131 had glaucoma while bilateral cases had more >50% (675 eyes of 1250 eyes) with glaucoma. Glaucoma with significant changes in IOP with or without disc damage was seen in 32% of pigmentary and 39% of classical PXF forms with eyes with combined forms of PXF having around 50% with glaucoma at presentation compared to other forms, p<0.001.
Different phenotypic variants of PXF in this Indian cohort was associated with 30-50% risk of OHT or glaucoma respectively. Adequate care is required while examining the pattern of PXF in each case to prognosticate each patient/eye.
评估假性剥脱综合征的不同临床变体及其发生高眼压（OHT）或青光眼（PXG）的风险。
基于医院的横断面研究。
印度东部一家三级眼科护理中心青光眼门诊的所有患者。
对医院数据库进行电子病历搜索，包括2013年4月至2015年3月期间连续的新病例和旧病例，以检索患者临床电子病历任何部分中包括假性剥脱、PXF、PEX、PXG和假性剥脱性青光眼等病例敏感词。比较了具有放射状色素沉着、经典或联合形式PXF表型的眼睛的所有人口统计学和临床细节，包括眼别、沉积物模式、用药需求和就诊时的视盘损害情况。
在2013 - 2015年期间就诊的110313例PXF患者中，共识别出1150例PXF患者的2297只眼睛，其中525例为单侧PXF（即共有1775只PXF眼睛，625例患者为双侧患病，n = 1250只眼睛，另一只临床正常眼睛，n = 522）。在525只单侧PXF眼睛中，105只患有高眼压，131只患有青光眼，而双侧病例中超过50%（1250只眼睛中的675只）患有青光眼。与其他形式相比，色素沉着型PXF中32%、经典型PXF中39%的眼睛出现眼压显著变化且伴有或不伴有视盘损害的青光眼，联合型PXF眼睛中约50%在就诊时患有青光眼，p<0.001。
该印度队列中PXF的不同表型变体分别与30% - 50%的高眼压或青光眼风险相关。在检查每个病例的PXF模式时需要充分关注，以便对每个患者/眼睛进行预后评估。
