STUDY OF PREVALENCE AND SYSTEMIC ASSOCIATION OF PSEUDOEXFOLIATIVE SYNDROME IN TERTIARY CARE CENTRE OF INDIA

• SANIA RAJESH GULWANI,*  
• Dr Kamini Mukeshkumar Prajapati

Abstract

BACKGROUND Pseudoexfoliation syndrome (PEX) is characterized by the deposition of fibrillar material in ocular and extraocular tissues. It originates from various ocular structures such as the lens capsule,ciliary body,corneal endothelium,zonules,and iris,with deposits found in extraocular tissues like liver,lung,kidney,gall bladder and meninges. The study provides valuable insights into the occurrence and impact of PEX on both ocular and systemic health, contributing to a comprehensive understanding of this condition. METHODS It is a hospital-based prospective observational cross-sectional study.200 eyes were examined and classified based on the presence of features of PEX syndrome with or without glaucomatous change in relation to any systemic conditions if present. A comprehensive history,assessment of best-corrected visual acuity and anterior segment evaluation was conducted using slit lamp biomicroscopy .Detailed glaucoma examination was done using Ultrasonic pachymeter(corneal thickness,Goldman applanation tonometer(intraocular pressure),Zeiss 4 mirror gonioscopy( angles examination),Octopus automated static perimeter (900) for Visual field testing and optic nerve head evaluation using slit lamp biomicroscopy with a 90D lens.Furthermore, routine blood investigations, diabetic profile, ECG, 2D echo, chest X-ray,thyroid profile, serum immune profile,audiometry,and the collection of CT and MRI imaging reports, if available with patient, were included in the overall assessment. RESULTS Over the span of two years,2489 patients were screened and PEX syndrome was found in 100 patients (200 eyes) making it 4% prevalent,revealing a peak incidence in the 61-70 age group, with female predominance being 57%. 50 eyes(26%)were diagnosed with angle closure glaucoma,28 eyes(14%) with open angle glaucoma,72 eyes(36%) were glaucoma suspects and rest 50 eyes (26%) did not have any glaucomatous changes.Systemic associations ranked as follows: Hypertension(76%) > Diabetes Mellitus(62%) > Sensorineural Hearing Loss(38%) > Ischemic Cardiac Condition(34%)>Alzheimer's Disease(14%) > Bronchial Asthma(7%) >thyroid issues(6 %)>HIV(3%), and prostate cancer(1%). The conclusion underscored PEX as a definite risk factor for glaucoma development,consolidating insights into demographic patterns,ocular complications,and systemic associations in PEX patients

Keywords

Pseudoexfoliative syndrome(PEX SYNDROME) , intraocular pressure(IOP) , Glaucoma, Systemic Illness