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Ultrasound biomicroscopic classification of zonules in exfoliation syndrome
Kosuke Inazumi1, Daisuke Takahashi, Toru Taniguchi
1Department of Ophthalmology, Gifu University School of Medicine, Japan.
Purpose:
Exfoliation changes in the zonules or ciliary processes may be the earliest clinical sign of the exfoliation syndrome (XFS). In the present study we investigated the usefulness of ultrasound biomicroscopy (UBM) for detecting the early changes of XFS in zonules.
Methods:
Both eyes of 11 patients with unilateral XFS and the unilateral eyes of 11 subjects without evidence of XFS were examined using UBM. The incidence of zonular changes was compared among the XFS-positive eyes of the patients, their contralateral XFS-negative eyes, and the healthy eyes of the subjects without XFS.
Results:
Using UBM, we could successfully describe the zonules in all UBM images of all subjects. In the four quadrants, the incidence of granular-type zonules was statistically different among the three groups: it was higher in XFP-positive eyes than in XFS-negative eyes, and it was higher in XFS-negative eyes than in healthy eyes.
Conclusions:
UBM can detect the zonular changes that may occur early in XFS. A granular-type change in the zonules may be the most typical finding in the presence of exfoliation material. Diagnostic criteria are proposed for the early detection of XFS, based on the changes found in the zonules by UBM.