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Basic Science and Pathogenesis.
Jeong Ho Han1, Heewon Bae2, Eun Joo Choi3
1Department of Neurology, Veterans Health Service Medical Center, Seoul, Korea, Republic of (South).
Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 23, 2025
Summary
Pseudoexfoliation syndrome is linked to increased brain atrophy, suggesting a higher risk for Alzheimer's disease (AD). This eye condition may serve as an early predictor for AD development.
Area of Science:
- Ophthalmology
- Neurology
- Geriatrics
Background:
- Pseudoexfoliation (PEX) syndrome involves extracellular material accumulation in the eye.
- Amyloid, a component found in PEX material, is also implicated in Alzheimer's disease (AD) pathogenesis.
- Amyloid deposition in AD leads to brain atrophy, prompting investigation into a similar link with PEX.
Purpose of the Study:
- To investigate the association between Pseudoexfoliation syndrome and brain atrophy.
- To determine if PEX syndrome is linked to an increased incidence of Alzheimer's disease (AD).
Main Methods:
- Retrospective cohort study of 48 PEX patients and 48 controls (Jan 2015 - Aug 2021).
- PEX patients were categorized into groups with or without glaucoma.
- Brain atrophy assessed via visual rating scale; AD incidence and MMSE scores were recorded.
Main Results:
- Significantly higher rates of medial temporal, global cortical, and parietal atrophy observed in the PEX group compared to controls (p < 0.05).
- No significant difference in brain atrophy between PEX syndrome and PEX glaucoma groups.
- Alzheimer's disease incidence was higher in the PEX group (16 participants) than in the control group (5 participants).
Conclusions:
- Pseudoexfoliation syndrome is associated with brain atrophy, indicating a potential risk factor for Alzheimer's disease.
- PEX glaucoma patients may represent more advanced stages of AD.
- PEX syndrome may serve as a predictor for the early stages of Alzheimer's disease.
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