摘要:

Abstract.The exfoliation syndrome affects all structures of the ocular anterior segment, as well as the conjunctiva and occasionally, nonocular structures. The exfoliative material has been shown by a series of light microscopic and gross anatomic studies to be only loosely adherent to the anterior lens capsule, zonules and anterior vitreous face, and firmly adherent to the equatorial lens capsule and posterior epithelium of the iris and the nonpigmented ciliary epithelium. Electron microscopy demonstrates that, in these latter regions, exfoliation material consisting of characteristic, cross‐banded fibrils embedded in an amorphous matrix, is present both within the epithelial cells and associated with a disorganized, reduplicated basement membrane. These findings suggest that the material arises from the epithelium of the lens, iris and ciliary body, possibly the result of an underlying metabolic disorder. From these areas, the material enters the aqueous humor and later deposits on the anterior lens capsule, zonules, vitreous face, anterior surface of the iris, and trabecular meshwork.Histochemical studies demonstrate the presence of glycosaminoglycans, which may comprise the interfibrillar portion of the exfoliative material. Other studies demonstrate histochemical similarities between exfoliative material and zonules and are supported by recent work suggesting that the exfoliative fibrils are related to the microfibrillar portion of elastin. Although some reports suggest similarities between exfoliative material and amyloid, a majority of histochemical studies do not support this possibilit

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1988.tb02624.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.Exfoliation fibrils have a characteristic ultramicroscopi appearance. They are 20–30 nm thick with 10 nm subunits and may be 800 or 900 nm long. They sometimes have a characteristic banding periodicity of about 50 nm. The fibrils have been located in the lens capsule, zonular threads, iris, ciliary body and trabecular meshwork. Extraocular locations have also been found in conjunctival vessels and retroorbital tissu

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1988.tb02625.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1988.tb02626.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.Scheimpflug photography is a very useful method in the diagnosis of exfoliation. It helps to differentiate between tiny subcapsular opacifications and supracapsular appositions. It is a valuable aid in the detection of early stages of exfoliation still unvisible at ordinary slit lamp examination. New phenomenons might be detected in the future like the elevation of a precapsular membrane in one of our patients.

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1988.tb02627.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.The clinical picture of the chamber angle in capsular glaucoma is described. One or more waves of pigment overpass Schwalbe's line and accumulate on the posterior face of the cornea. These waves are found in the chamber angle between 4 and 8 o'clock across 6 o'clock. The pathological anatomy of the chamber angle in the exfoliation is studied with light microscopy, scanning electronmicroscopy and transmission electronmicroscopy in relation with the material of pseudoexfoliation and pigment granules and the difference with the pigmentary glaucoma is shown.

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1988.tb02628.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.A retrospective follow‐up study of 206 eyes with exfoliation in 164 patients was carried out. At the time exfoliation (EX) was initially diagnosed, there were 97 patients with unilateral and 42 patients (84 eyes) with bilateral exfoliation. In 25 patients the exfoliation was connected with hypertension or glaucoma in the fellow eye.The average age of the patients with unilateral EX was 66.3 years and that of the patients with bilateral EX 68.0 years. The initial mean IOP (±SD) of 17.9 (±2.9) mmHg in 97 unilateral EX eyes was statistically significantly higher (2p<0.001) than in the normal fellow eye 16.1 (±2.5) mmHg.Of the 97 eyes with unilateral EX, 45.3 % with an initial mean IOP of 17.4 mmHg remained unchanged. The mean follow‐up time was 5.0 years. Conversion of unilateral to bilateral EX was observed in 14.4 % of cases. The mean time of conversion was 4.5 years. Of the 84 bilateral EX eyes with an initial mean IOP of 17.0 mmHg, 66.7 % remained unchanged.Of the total sample of 206 EX eyes, 65.5 % remained normotensive and 34.5 % developed hypertension or glaucoma during the follow‐up period. The initial mean IOP of those eyes which remained normotensive was statistically significantly lower than that of those which later on developed hypertension or glaucoma (2

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1988.tb02629.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.Two studies, both retrospective, were done at our institution. The first study evaluated 100 consecutive patients with exfoliation (EX) syndrome found as an incidental finding in a private, general ophthalmology practice, to determine the incidence of glaucoma. The second determined the long‐term course of EX as it relates to the onset of elevated intraocular pressure (IOP). In the first study, of 124 eyes having EX 78 % had normal IOP, 15 % had intraocular pressure greater then 22 mm Hg but no cupping or field loss (ocular hypertension or glaucoma suspect), and 7 % had glaucoma. In the second study 347 patients who initially had normal IOPs and either unilateral or bilateral EX were followed over time. Elevated IOP developed in 35 patients (44 eyes) during the study. The cumulative probability for eyes with EX to develop elevated intraocular pressure was 5.3 % in 5 years and increased to 15.4 % in 10 years. These probabilities predict that patients with EX have a higher incidence of developing elevated intraocular pressure than would be expected in patients without EX of similar ag

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1988.tb02630.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.95 eyes of patients with bilateral exfoliation syndrome (ES) were examined with fluoroangiography. The visual field and the intraocular pressure were tested in the same eyes. The relationship between visual field defects, fluoroangiographic changes of the optic disk and intraocular hypertension is discussed. The results show that when hypertension and defects of perfusion are present in the same eye the visual field defect is always present and it is more severe.

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1988.tb02631.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.Patients with monolateral exfoliation syndrome were examined to elucidate the differences between the eye with the exfoliation and the fellow eye and to explain the damage of the visual field of the eyes with or without exfoliation.The greatest difference between the two groups of eyes is represented by an increased pigmentation of the anterior chamber angle. The visual field, as in bilateral cases, showes the greates damage when exfoliation and hypertension are present together in the same eye. An hypothesis is put forward to explain the supposed mechanism of action of these two factors.

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1988.tb02632.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.This introductory lecture to the epidemiological session in the Workshop on the Exfoliation Syndrome (ES) gathers together figures for the prevalence of ES around the world. Prevalence figures from published reports are shown in the text separately for each country. Four ways of comparing the prevalences are used. 1) Prevalences in people over 60 years of age, 2) Percentages of glaucoma in persons with ES, 3) Percentages of ES in patients with glaucoma or ocular hypertension, with separate statistics for the proportion of capsular glaucoma in patients treated with laser trabeculoplasty (LTP), 4) Prevalence of ES in patients with cataract. The major differences in prevalence can partly be explained by the different techniques used in the investigations. Very few authors have studied people in different countries, which is the best way of obtaining comparable results. The author has personally studied Finns, Lapps, Eskimos in Greenland, Canada and Alaska, Icelanders, populations in Tunis, India and Peru and four populations in the USSR by the same technique. The prevalences vary from 0 % in Eskimos to 21 % in Finns over 60 years of age, and are at the same high level in Lapps, Finns, Russians in Novosibirsk and Icelanders, but significantly lower in all the others. The results support the opinion that ES is not uniformly distributed in all countries, and this is confirmed by many reports from different countries in this workshop.

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1988.tb02633.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY