Keratometry and axial length in pigment dispersion syndrome: a descriptive case-control study

Transient visual blurring during a sexual intercourse in a young woman with surgically corrected myopia and unrecognized pigmentary glaucoma: A rare case report

PURPOSE

To present a rare case of unilateral visual loss episodes occurred during sexual intercourse in a young patient affected by unrecognized pigmentary glaucoma and previously undergone myopic refractive surgery.

CASE DESCRIPTION

The patient presented surgically flattened corneas and markedly asymmetric pigmentary glaucoma.

CONCLUSIONS

Previous refractive surgery, sexual intercourse, and athletic lifestyle might be risk factors for acute pigment dispersion and chronic progression of pigmentary glaucoma in young myopic patients. During their ophthalmic examination prior to refractive surgery, greater attention should be paid to detect early signs of pigmentary dispersion, and awareness of these dangerous situations should be raised in affected patients.

The Heritability of Pigment Dispersion Syndrome and Pigmentary Glaucoma

PURPOSE

Pigment dispersion syndrome (PDS) and pigmentary glaucoma (PG) are presumed to be inherited in an autosomal dominant manner. We examine relatives of patients with PDS and PG in order to determine the heritability of these diseases.

DESIGN

This was a prospective, cross-sectional study.

METHODS

One hundred and one patients with PDS were prospectively recruited over 11 months. Four of the patients had PDS without ocular hypertension or glaucoma, 6 had PDS and ocular hypertension, and 91 had PG. Criteria for PDS were 2 of 3 signs: Krukenberg spindle, midperipheral iris transillumination defects, and/or heavy trabecular meshwork pigmentation. Criteria for PG were PDS and 2 of 3 signs: intraocular pressure >21 mm Hg, glaucomatous optic nerve damage, and/or glaucomatous visual field loss. Ninety-nine first-degree relatives living within a 100-mile radius of Iowa City, Iowa were examined in the clinic to determine the probability of familial transmission.

RESULTS

A total of 10 of 99 (10.10%) first-degree relatives were diagnosed with PDS (1 with PDS alone, 2 with PDS and ocular hypertension, and 7 with PG). Seven families with ≥2 affected members were identified. The majority of affected family members (8/10) showed moderate to heavy trabecular meshwork pigmentation and either Krukenberg spindle or transillumination defects.

CONCLUSIONS

Most of the cases of PDS in our study were sporadic, and the risk to first-degree relatives is lower than previously reported. However, there are families with apparent autosomal dominant inheritance of PDS in which the risk to relatives may be high.

Outcomes of laser in situ keratomileusis in patients with pigment dispersion syndrome

PURPOSE

To analyze the outcome of laser in situ keratomileusis (LASIK) in patients with pigment dispersion syndrome (PDS).

SETTING

Outpatient ambulatory laser vision correction centers.

METHODS

This noncomparative case series reviewed the medical records of 12 patients (22 eyes) who had clinical features consistent with PDS at the time of the initial preoperative refractive evaluation and had LASIK surgery.

RESULTS

Twenty eyes (90.9%) of 11 patients had an uneventful course after LASIK and a good final uncorrected visual acuity (mean follow-up 26 months). One patient (2 eyes) with PDS and suspicion of glaucoma on topical beta-blocker therapy had delayed healing, fluctuations in vision, and a lengthy visual recovery.

CONCLUSIONS

Corneal findings of PDS do not appear to affect the intraoperative or postoperative outcomes of LASIK. However, patients who have PDS in the context of glaucoma and therapy with an intraocular-pressure-lowering agent may experience delayed healing and a less predictable visual outcome.