Exfoliation syndrome: a disease with an environmental component

Area of Science:

• Ophthalmology
• Genetics
• Environmental Health

Background:

• Exfoliation syndrome (XFS) is a primary cause of secondary open-angle glaucoma, leading to significant ocular morbidity.
• Recent research suggests environmental factors play a crucial role in XFS development.
• This review synthesizes current knowledge on environmental influences in XFS pathogenesis.

Purpose of the Study:

• To review and elucidate the role of environmental factors in the development of exfoliation syndrome (XFS).
• To highlight recent findings linking environmental exposures to XFS risk.
• To explore potential preventive strategies based on environmental understanding.

Main Methods:

• Literature review of recent studies on exfoliation syndrome and environmental factors.
• Analysis of genetic and non-genetic risk factors associated with XFS.
• Synthesis of data on geographical, climatic, and dietary influences.

Main Results:

• Aberrant microfibril formation, cross-linked by lysyl oxidase like 1 (LOXL1), is implicated in XFS.
• While LOXL1 gene variants are common in XFS cases, they are also prevalent in controls, suggesting other factors are involved.
• Increased latitude, solar radiation, climate variables, high coffee consumption, and low dietary folate are associated with higher XFS risk.

Conclusions:

• Environmental components significantly influence exfoliation syndrome development.
• Identifying these factors may pave the way for lifestyle-based preventive strategies.
• Further research into environmental triggers can help mitigate the disease burden of XFS.