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Ursula M. Schlötzer-Schrehardt, PhD; Mahmut R. Koca, MD; Gottfried O. H. Naumann, MD; Hildegard Volkholz, MD

Arch Ophthalmol. 1992;110(12):1752-1756.

Abstract
• The pseudoexfoliation syndrome has recently been suggested to represent the local manifestation of a more widespread disorder. In this study, a case of classic bilateral pseudoexfoliation syndrome with systemic distribution of pseudoexfoliation material involving a variety of organ systems is described. Using transmission electron microscopy, typical pseudoexfoliation fibers were identified in autopsy tissue specimens of skin, heart, lungs, liver, kidney, and cerebral meninges in addition to the classic intraocular locations. The pseudoexfoliation material was mainly localized to connective-tissue portions or septa traversing the various organs. The pseudoexfoliation fibers were consistently associated with connective-tissue components, particularly fibroblasts and collagen and elastic fibers; myocardial tissue specimens; and heart-muscle cells. These findings provide evidence for the systemic nature of the pseudoexfoliation syndrome, which apparently involves an aberrant connective-tissue metabolism throughout the body.

Author Affiliations
From the Department of Ophthalmology, University of Erlangen-Nürnberg (Federal Republic of Germany) (Drs Schlötzer-Schrehardt, Koca, and Naumann), and the Department of Pathology, Städtisches Klinikum Nürnberg (Dr Volkholz).

Footnotes
Accepted for publication July 6, 1992.

Reprint requests to the Department of Ophthalmology, University of Erlangen-Nürnberg, Schwabachanlage 6, W-8520 Erlangen, Federal Republic of Germany (Dr Schlötzer-Schrehardt).

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