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Visual impairment in pseudoexfoliation from four tertiary centres in India
Aparna Rao1, Niranjan Raj1, Amiya Pradhan1
1LV Prasad Eye Institute, Patia, Bhubaneswar, India.
Plos One
|May 30, 2020
Summary
Pseudoexfoliation disease significantly impacts vision, causing over 30% visual impairment and 28% blindness. Early staging and comorbidity assessment are crucial for managing this hidden glaucoma burden and preventing vision loss.
Area of Science:
- Ophthalmology
- Glaucoma Studies
- Public Health
Background:
- Pseudoexfoliation (PXF) is a condition that can lead to increased intraocular pressure (IOP) and glaucoma.
- Understanding the disease burden across different stages of PXF is essential for effective management.
Purpose of the Study:
- To analyze the disease burden of pseudoexfoliation (PXF) across its various stages in East and South India.
- To determine the rates of visual impairment and blindness associated with PXF, ocular hypertension (OHT), and pseudoexfoliation glaucoma (PXG).
Main Methods:
- A prospective hospital-based study involving 3142 patients (6284 eyes) across four tertiary centers in India.
- Data collection included clinical and demographic details, visual acuity, IOP, and comorbidities, analyzed using WHO visual criteria and multivariate logistic regression.
Main Results:
- Pseudoexfoliation glaucoma (PXG) was observed in 29% of eyes, with 3676 eyes (over 50%) being bilateral.
- Rates of reversible visual impairment were 33% in PXF and 26% in OHT, primarily due to cataracts.
- Irreversible blindness was higher in bilateral PXG (30.5%) compared to PXF (23.2%) or OHT (21.6%), with an overall absolute blindness rate of 28.2%.
Conclusions:
- Pseudoexfoliation is linked to substantial visual impairment (≥30%) and a high rate of absolute blindness (28%), indicating a significant, often overlooked, glaucoma burden.
- Accurate disease staging and assessment of comorbidities at baseline are vital for prognostication and reducing preventable blindness caused by pseudoexfoliation.
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