[Acute attacks in pseudoexfoliative glaucoma]

Area of Science:

• Ophthalmology
• Glaucoma Research
• Ocular Pathology

Context:

• Pseudoexfoliation glaucoma (PEG) is a common form of secondary glaucoma.
• Acute attacks in PEG can be challenging to diagnose due to atypical clinical presentations.
• Accurate diagnosis and timely treatment are crucial for preserving vision.

Purpose:

• To describe the clinical features of acute attacks in open-angle pseudoexfoliative glaucoma.
• To evaluate the treatment outcomes of surgical interventions for these acute attacks.
• To identify characteristic dystrophic changes associated with pseudoexfoliative glaucoma attacks.

Summary:

• This study analyzed 23 eyes with acute pseudoexfoliative glaucoma attacks, noting frequent misdiagnoses (47.9%) due to subtle symptoms like minimal pain, normal anterior chamber depth, and corneal edema.
• Gonioscopy revealed open angles with significant pseudoexfoliative material pigmentation.
• Surgical treatments, including trabeculectomy and deep sclerectomy (with or without cataract extraction), were performed on 20 eyes. Post-operative intraocular pressure normalized in 19 eyes, though visual acuity outcomes ranged from 0.1-0.3 to 0, with advanced glaucoma in most cases.

Impact:

• Highlights the diagnostic challenges posed by pseudoexfoliative glaucoma acute attacks.
• Demonstrates the efficacy of surgical management in controlling intraocular pressure.
• Underscores the importance of recognizing dystrophic changes in pseudoexfoliative glaucoma for improved patient care and visual prognosis.