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Why is glaucoma associated with exfoliation syndrome?
Robert Ritch1, Ursula Schlötzer-Schrehardt, Anastasios G P Konstas
1Department of Ophthalmology, The New York Eye and Ear Infirmary, 310 East 14th Street, 10003 New York, NY, USA. ritchmd@earthlink.net
Progress in Retinal and Eye Research
|July 11, 2003
Summary
Exfoliation syndrome (XFS) is an extracellular matrix disorder causing glaucoma. It involves fibrillar material accumulation, leading to increased eye pressure and vision loss.
Area of Science:
- Ophthalmology
- Extracellular Matrix Biology
- Glaucoma Research
Background:
- Exfoliation syndrome (XFS) is an age-related disorder affecting the extracellular matrix.
- It is characterized by the accumulation of fibrillar material in ocular and visceral tissues.
- Mature exfoliation fibrils are 8-10 nm microfibrils, similar to elastic microfibrils.
Purpose of the Study:
- To elucidate the composition and pathological role of exfoliation material (XFM).
- To understand the mechanisms by which XFS causes glaucoma.
- To identify factors contributing to angle-closure in XFS patients.
Main Methods:
- Analysis of fibril composition (implied).
- Clinical observation of anterior segment changes.
- Pathophysiological correlation of matrix deposition and intraocular pressure.
Main Results:
- XFM is a complex glycoprotein/proteoglycan structure with protein cores and glycoconjugates.
- XFS is the leading cause of open-angle and angle-closure glaucoma.
- Iridolenticular friction and trabecular meshwork involvement contribute to elevated intraocular pressure.
Conclusions:
- XFS involves a generalized matrix disorder with significant ocular consequences.
- Trabecular cell dysfunction and matrix deposition are key to pressure elevation in XFS.
- Understanding XFS pathophysiology is crucial for managing glaucoma associated with this syndrome.