In a patient with pigment dispersion syndrome, the most significant ocular risk factor for conversion to glaucoma is an IOP above 21mmHg on presentation

The Science behind the Tip

Pigment dispersion syndrome tends to occur in young myopic white men. There are genetic factors that underly the risk for conversion from pigment dispersion to glaucoma (1). Up to 10% develop glaucoma at 5 years and 15% at 15 years (2). In some individuals it may take more than 20 years (3).

Men tend to develop glaucoma at an earlier age than women and are more likely to require more aggressive treatment (4). The most significant ocular factor for conversion to glaucoma is an IOP above 21mmHg on presentation (2). Age, refractive error, family history, degree of trabecular hyperpigmentation and cup: disc ratio are not predictors of who will develop glaucoma (2).

Contributor: John F Salmon MD - Oxford Eye Hospital - UK

References

1. Lascaratos G, Shah A, Garway-Heath DF – The genetics of pigment dispersion syndrome and pigmentary glaucoma Surv Ophthalmol 2013; 58: 164-175.

2.Siddiqui Y, Ten Hulzen RD, Cameron JD et al. What is the risk of developing pigmentary glaucoma from pigment dispersion syndrome. Am J Ophthalmol 2003; 135: 794-799.

1. Migliazzo CV, Shaffer RN, Nykin R, Magee S. Long term analysis of pigment dispersion syndrome and pigmentary glaucoma. Ophthalmology 1986; 93: 1528-1536.

2. Farrar SM, Shields MB, Miller KN, Stoup CM. Risk factors for the development and severity of glaucoma in the pigment dispersion syndrome. Am J Ophthalmol 1989; 108: 223-229.

Tip Reviewer: Roger Hitchings
Tip Editor: John Salmon