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Pseudoexfoliation Glaucoma
Glaucoma
Key Points
- •PXFG is the most common identifiable secondary open-angle glaucoma and accounts for 25-30% of OAG globally.
- •PXF syndrome converts to PXFG in about 15% at 5 years and 44% at 15 years; conversion is not inevitable.
- •LOXL1 on chromosome 15q24.1 is the major genetic determinant, with rs1048661/R141L and rs3825942/G153D as key SNPs.
- •The classic 3-zone anterior lens capsule pattern is visible only after mydriasis.
- •Sampaolesi's line is pigment anterior to Schwalbe's line and is characteristic, not pathognomonic, because it occurs in both PXF and PDS.
- •Single clinic IOP may be normal in 15-20% of PXFG eyes; measure IOP at different times or perform diurnal/24-hour phasing when clinic IOP is discordant with damage, progression continues despite target IOP, or high fluctuation is suspected.
- •RNFL loss greater than 1.0 micrometer/year on OCT trend analysis is significant progression.
- •PXF cataract surgery needs proactive zonular and pupil planning, including CTR or modified CTR when indicated.
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Keep reading Pseudoexfoliation Glaucoma
12 more sections are included with the Clinical plan.
- Definition, Epidemiology, Conversion
- LOXL1 and Pathogenesis
- Slit Lamp, Gonioscopy, IOP
- Progression and Workup
- Differentials
- Medical and Laser Management