Lecture 9 - Pseudoexfoliation syndrome and glaucoma a dangerous dup Flashcards Preview

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Flashcards in Lecture 9 - Pseudoexfoliation syndrome and glaucoma a dangerous dup Deck (43)
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1

What type of profession commonly get PES (pseudo exfoliation syndrome)

Glass blowers

Note: No protection against infared radiation

2

What type of cases is PES associated with?

1. Inflammation
2. Trauma
3. Older age

3

What are the deposits considered to be?

Distinctive Fibrillar material

4

When is PES seen after what ocular procedure?

Post dilation

5

Where is the PES material the visable the most?

Pupillary Edge

6

What is the percentage that PES/XFS may form into exfoliation glaucoma?

30% in a lifetime

7

According to many studies, which group had the highest prevalance in PES?

Middle Finland at 21% and Middle Sweden at 18%

8

Which three countries showed PES to show up in individuals slightly after 40 YO?

1. Saudi Arabia
2. South Africa
3. Southern India

9

Which country showed the highest prevalance of XFG in XFS pts?

Australia

10

Which gender is common in getting XFG?

Female

11

What are 3 features of XFS?

1. Central disc (corresponds to size of pupil)
2. Clear zone - removal of material by iris movement
3. Peripheral granular zone due to undisturbed accumulation

12

What two lens findings will you find due to degenerative changes in zonular fibers?

1. Phacodeonesis
2. Subluxation of lens

13

What type of XFS enzyme is found on zonules?

Proteolytic enzymes

14

What are three post op complications that may occur after removal of a cataract?

1. Production of XFS material continues
2. Late decentration of lens
3. Subluxation of lens implant

15

When preforming retroillumination with a slit lamp you notice the iris to look like moths have eaten it, what is this defect called?

Iris Transillumination defects

Note: You will most likely even observe a Loss of pupillary ruff

16

An iris will change and is shown by Fluorescein angiography. What three changes will be seen?

1. Hypoperfusion
2. Neovascularization
3. Increase with age and duration of disease

Note: This is due to vessls being blocked and causing hypoxia

17

True or False. When preforming Gonio, will you notice a uniform coverage of the TM 360?

False. It is uneven. You will notice the TM is heavily pigmented and there will be pigment deposition on Schwalbe's line

18

Which layer of the cornea may show some adhering XFS material?

Endothelium - shows low cell density and morphological signs will be seen

19

Is exfoliation syndrome a bilateral or unilateral disease?

Unilateral... More common in Japanese population, which showed unilaterally

20

If there is elevated IOP, you will see decreased blood flow. Which of the two, XFG or XFS, will show impaired blood flow?

XFG

Note: There is low blood flow for both but higher instance in XFG

21

Since there is not a direct correlation between XFG and systemic diseases. However one thing they have is an increased _________ rate.

Morbidity

Note: Davey has a slide which says that XFS is a systemic disease but exaggerating systemic diseases remains to be clarified

22

XFS and XFG have elevated plasma homocystein levels, which lead to an increase risk of?

Venous occlusion

Note: Mild hearing loss is also reported

23

True or False. Exfoliation increases the relative risk of glaucoma?

True

24

True or False. Adjusting IOP will change the relationship between XFS and glaucoma?

False.

25

True or False. XFS without high IOP is an independent risk factor in glaucoma development?

True

26

What are the two mechanisms of XFG?

1. Exfoliation material found in posterior ciliary artery
2. Vortex veins

27

What is the risk amount of have glaucoma due to ocular htn?

3.7 times

28

True or False. Degree of pigmentation and exoliation material in angle correlates postively with IOP?

True

29

True or False. There no correlation between normotensive eyes with XFS elevation of IOP.

False. There is direct correlation.

5.3% over 5 years
15.4% over 10 years

30

Glaucoma is ____ as common in XFS with ocular htn when compared to only ocular htn

twice

Note: The rim becomes less when XFS becomes XFG