Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
PLoS One. 2022 Jun 23;17(6):e0268864. doi: 10.1371/journal.pone.0268864. eCollection 2022.
Myopia is a known risk factor of pigmentary glaucoma (PG), and the increased prevalence of myopia in Asian countries indicates that more cases of PG will likely develop soon. However, there are no diagnostic criteria for PG for Asians. Therefore, the purpose of this study is to determine the characteristics of PG in Japanese individuals and establish three diagnostic signs for PG.
This was a single-center, retrospective, case series study of glaucoma patients who visited the Kagoshima University Hospital between January 2015 and January 2020. The inclusion criteria were age <50 years at time of diagnosis and presence of pigmentation in the anterior chamber (AC) angle including a Sampaolesi line. Eyes with pigmentation of the AC angle caused by other types of glaucoma such as uveitis, trauma, exfoliation, or childhood glaucoma were excluded. We investigated the classic diagnostic triad of signs of PG; posterior corneal pigmentation, mid peripheral iris transillumination defect, and pigmentation of the trabecular meshwork. We also examined the Sampaolesi line, iris concavity, and midperipheral iris depigmentation in eyes with PG.
Ten eyes of 5 Japanese men and 10 eyes of 5 Japanese women were studied. Their age ranged from 13 to 46 years at the time of diagnosis. One eye had posterior corneal pigmentation and 6 eyes had pigmentation of the trabecular meshwork. None had mid peripheral iris transillumination defect. The Sampaolesi line, iris concavity, and midperipheral iris depigmentation were found in all patients except one patient who lacked the mid peripheral depigmentation. Two eyes had the pigment reversal sign, none had lens pigmentation, and 2 eyes had peripheral retinal degeneration.
The presence of the Sampaolesi line, iris concavity, and midperipheral iris depigmentation may be appropriate signs for the diagnosis of PG in Asians.
近视是色素性青光眼（PG）的已知危险因素，亚洲国家近视患病率的增加表明，未来可能会有更多的 PG 病例出现。然而，亚洲人没有 PG 的诊断标准。因此，本研究的目的是确定日本人 PG 的特征，并建立 PG 的三个诊断标志。
这是一项单中心、回顾性、病例系列研究，纳入了 2015 年 1 月至 2020 年 1 月期间在鹿儿岛大学医院就诊的青光眼患者。纳入标准为诊断时年龄<50 岁，房角存在色素沉着，包括 Sampaolesi 线。排除因葡萄膜炎、外伤、剥脱、儿童青光眼等其他类型青光眼引起的房角色素沉着的眼。我们研究了 PG 的经典诊断三联征：后角膜色素沉着、周边虹膜不透光缺陷和小梁网色素沉着。我们还检查了 PG 眼中的 Sampaolesi 线、虹膜凹陷和周边虹膜脱色素。
研究纳入了 5 名日本男性和 10 名日本女性的 10 只眼。诊断时年龄为 13-46 岁。1 只眼有后角膜色素沉着，6 只眼有小梁网色素沉着。无一例出现周边虹膜不透光缺陷。除 1 例患者缺乏周边脱色素外，所有患者均存在 Sampaolesi 线、虹膜凹陷和周边虹膜脱色素。2 只眼有色素反转征，无一例晶状体色素沉着，2 只眼有周边视网膜变性。
Sampaolesi 线、虹膜凹陷和周边虹膜脱色素可能是亚洲人 PG 诊断的合适标志。
