Pigment dispersion syndrome and pigmentary glaucoma. Contemporary diagnostics and therapeutic approach
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Abstract
Pigment dispersion syndrome (PDS) is a disease with excessive pigment particles release from the pigment epithelium of iris. Among the possible causes of this clinical condition reverse pupillary block, defective epithelial cells and genetics are mentioned. Because of the obstruction in aqueous humor outflow through trabecular meshwork, intraocular pressure may be elevated incidentally or permanently, leading to secondary pigmentary glaucoma (PG) development. The most important diagnostic test in patients with PDS and PG include: biomicroscopy, iris retroilumination, gonioscopy, ultrabiomicroscopy (UBM), anterior segment optical coherence tomography (AS-OCT) and other imaging typical for glaucoma: perimetry, scanning laser polarimetry (GDx), nerve fiber layer SOCT and scanning laser ophthalmoscopy (HRT). In PDS and PG several therapeutic options are used: topical hypotensive pharmacotherapy, peripheral laser iridotomy in presence of the reverse pupillary block and laser procedures performed on iridocorneal angle, especially selective laser trabeculoplasty (SLT). In some cases filtration surgery is also needed.
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