Preclinical diagnosis of pseudoexfoliation syndrome
A. M. Prince, B. W. Streeten, R. Ritch, A. J. Dark and M. Sperling
Although the diagnosis of pseudoexfoliation syndrome (PXS) is made by
observation of pseudoexfoliation material (PXM) deposited on the anterior
lens capsule, there are several additional signs related to pigment
dispersion that are often present both in eyes with PXS and fellow eyes in
unilateral cases. On the basis of the presence of these signs, we have
categorized a group of patients as "pseudoexfoliation suspects" who
demonstrated no evidence of PXM on the lens capsule in either eye. As PXM
has previously been identified in the conjunctiva of affected eyes as well
as fellow eyes in unilateral cases, we hypothesized that it could also be
present in PXS suspect eyes. Inferior bulbar conjunctival biopsies were
performed on four eyes with PXS, five fellow eyes, and 23 PXS suspect eyes,
and specimens were examined by transmission electron microscopy. In eight
PXS suspect eyes biopsy specimens demonstrated PXM, suggesting that PXS is
more prevalent and possibly responsible for a greater proportion of
glaucoma than previously suspected.
