Nobl Matthias, Mackert Marc
Klin Monbl Augenheilkd. 2021 Apr 19. doi: 10.1055/a-1472-0471.
Pigment dispersion syndrome (PDS) is a disorder predominantly affecting young, myopic adults. It is characterised by the liberation of pigment of the iris and deposition of it on various structures of the anterior segment leading to multiple specific findings in slit lamp examination. Typical alterations are a deposition of pigment on the central corneal endothelium, circular iris transillumination defects in the mid periphery, a posterior bowing of the iris and increased pigmentation of the trabecular meshwork. Findings are usually bilateral symmetric. Posterior bowing of the iris causes rubbing of the pigmented iris epithelium against lens structures like zonular fibres with a consecutive liberation of pigment. Trabecular meshwork changes because of pigment deposition reduce aqueous outflow facility with the risk of elevated intraocular pressure and glaucoma. Pigmentary glaucoma (PG) is a secondary open angle glaucoma. Treatment of PG is similar to primary open angle glaucoma, including medical therapy, laser therapy and surgery. Peripheral laser iridotomy was shown to change iris configuration but its efficacy in the prevention of PG has not been confirmed in the literature. The purpose of this paper is to summarize information regarding ocular manifestations of PDS to facilitate an early diagnosis and to present a general view of the treatment of PG.
色素播散综合征(PDS)是一种主要影响年轻近视成年人的疾病。其特征是虹膜色素的释放及其在前房各结构上的沉积,导致裂隙灯检查出现多种特定表现。典型改变包括色素在中央角膜内皮的沉积、周边部虹膜的环形透照缺损、虹膜后凸以及小梁网色素沉着增加。这些表现通常双侧对称。虹膜后凸导致色素性虹膜上皮与晶状体结构(如悬韧带纤维)摩擦,继而色素释放。由于色素沉积,小梁网发生改变,房水流出功能降低,存在眼压升高和青光眼的风险。色素性青光眼(PG)是一种继发性开角型青光眼。PG的治疗与原发性开角型青光眼相似,包括药物治疗、激光治疗和手术治疗。周边激光虹膜切开术可改变虹膜形态,但其预防PG的疗效尚未在文献中得到证实。本文旨在总结有关PDS眼部表现的信息,以促进早期诊断,并对PG的治疗进行概述。