Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab.
Medicine (Baltimore). 2021 Aug 6;100(31):e26567. doi: 10.1097/MD.0000000000026567.
To report the changes of trabecular meshwork (TM) pigmentation and clinical outcomes of patients with pigment dispersion syndrome (PDS) after resolution of reverse pupillary block.Twenty one eyes of 11 PDS patients were followed up periodically for 15 years after resolution of reverse pupillary block with either Nd: YAG laser peripheral iridotomy (LPI) or trabeculectomy. Visual acuity (VA), best-corrected visual acuity (BCVA), slit lamp examination, intraocular pressure (IOP), Humphrey visual field analysis (VFA), gonioscopy and stereoscopic funduscopy were performed on admission and every 6 months postoperatively. TM pigmentation was quantitatively evaluated and graded every 5 years after the treatment, in which the circumference of anterior chamber angle was divided into 4 quadrants: superior, inferior, nasal and temporal. Postoperative IOP, VA, BCVA, VFA, TM pigmentation and adjunctive anti-glaucoma medications were main outcome measurements and compared with baseline.Eleven patients (9 males, 2 females) were identified as PDS according to the diagnostic criteria, with average age of 38.25 ± 6.93 years (range, 31-55 years) at initial diagnosis. The mean IOP level was 33.1 ± 9.8 mmHg (range, 22-56 mmHg) at diagnosis. Ten PDS eyes received LPI, and the other eleven eyes underwent uneventful trabeculectomy. The median TM pigmentation score of the 21 PDS eyes was 16 (interquartile range [IQR], 15-16) on admission, which changed to 14 (IQR, 13-15), 13 (IQR, 12-14), 12(IQR, 10.5-12) at 5-, 10-, 15-year follow-up visits respectively. The decrease rate of TM pigmentation was 37% in inferior quadrant, while in nasal, temporal, and superior quadrant the reduction rate was 28%, 23%, and 18%, respectively, at the last follow-up visit. Majority of these enrolled eyes (19/21) had stable VA and BCVA with average endpoint IOP of 15.1 ± 3.4 mmHg.TM pigmentation in PDS patients attenuates with time after reverse pupillary block was resolved, in which the inferior quadrant seems faster than the other quadrants.
报告瞳孔阻滞反转后，色素播散综合征（PDS）患者小梁网色素沉着变化和临床结果。
采用 Nd:YAG 激光周边虹膜切开术（LPI）或小梁切除术治疗瞳孔阻滞反转后，11 例 PDS 患者 21 眼平均随访 15 年。于治疗前、治疗后 6 个月及之后，进行视力（VA）、最佳矫正视力（BCVA）、裂隙灯检查、眼压（IOP）、Humphrey 视野分析（VFA）、房角镜和立体眼底检查。采用定量方法评估 TM 色素沉着，并在治疗后每 5 年分级，前房角的圆周被分为 4 个象限：上、下、鼻和颞。术后 IOP、VA、BCVA、VFA、TM 色素沉着和辅助抗青光眼药物是主要的观察指标，并与基线进行比较。
根据诊断标准，11 例患者（9 例男性，2 例女性）被诊断为 PDS，初始诊断时的平均年龄为 38.25±6.93 岁（31-55 岁）。诊断时平均 IOP 水平为 33.1±9.8mmHg（22-56mmHg）。10 只 PDS 眼接受了 LPI，另 11 只眼行小梁切除术。21 只 PDS 眼的 TM 色素沉着评分中位数在就诊时为 16（四分位距 [IQR]，15-16），在 5 年、10 年和 15 年随访时分别变为 14（IQR，13-15）、13（IQR，12-14）和 12（IQR，10.5-12）。在最后一次随访时，下象限 TM 色素沉着减少率为 37%，而鼻侧、颞侧和上象限 TM 色素沉着减少率分别为 28%、23%和 18%。这些入组的大多数眼（19/21）具有稳定的 VA 和 BCVA，平均终末 IOP 为 15.1±3.4mmHg。瞳孔阻滞反转后，PDS 患者的 TM 色素沉着随时间推移而减轻，下象限似乎比其他象限更快。
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