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NR. 1/2008
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Jaskra barwnikowa –
patomechanizm, diagnostyka i leczenie
Pigmentary Glaucoma – Pathomechanism, Diagnostics and Treatment
Monika Udziela, Marta
Szymańska-Świderska, Anna Zaleska-Żmijewska, Jacek P. Szaflik
Katedra i Klinika Okulistyki II Wydziału Lekarskiego
Warszawskiego Uniwersytetu Medycznego
Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik |
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| Summary: |
In our article we describe
definition, epidemiology, pathogenesis, genetic aspects,
symptoms and signs, diagnostic methods, histology,
differentiation diagnosis and management of pigmentary
glaucoma including pharmacotherapy, laser therapy and
surgery. Pigmentary glaucoma (PG) typically develops in
young myopic patients with pigment dispersion syndrome (PDS).
PDS is characterised by melanin pigment liberation from
the iris pigment epithelium due to mechanical disruption
by lens zonules. Accomodation plays an important role in
this process. Criteria for pigment dispersion syndrome
are two out of three signs: Krukenberg spindle,
midperipheral radial iris transillumination defects or
heavy trabecular meshwork pigmentation. Criteria for
pigmentary glaucoma are: pigment dispersion syndrome and
two out of three findings: intraocular pressure greater
than 21 mmHg, optic nerve damage or visual field loss.
Ultrabiomicroscopy Examination (UBM) is especially
useful among various diagnostic methods.
Optical coherence tomography (OCT for anterior segment)
is another new method for anterior segment imaging.
Patients suffering from pigmentary glaucoma are treated
using pharmacotherapy as well as laser and surgery
management. Selective laser trabeculoplasty (SLT) is
safe and effective procedure in lowering intraocular
pressure and currently it should be the first-choice of
PG treatment. However its efficacy depends on stage of
the trabecular meshwork pigmentation. |
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| Key words: |
pigmentary dispersion
syndrome (PDS), pigmentary glaucoma (PG), selective
laser trabeculoplasty (SLT). |
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