Pigmentary Glaucoma and Pigment Dispersion Syndrome - EyeWiki
Pigment dispersion syndrome (PDS) and pigmentary glaucoma (PG) represent a spectrum of the same disease characterized by excessive pigment liberation throughout the anterior segment of the eye. The classic triad consists of dense trabecular meshwork pigmentation, mid-peripheral iris transillumination defects, and pigment deposition on the posterior surface of the central cornea. Pigment accumulation in the trabecular meshwork reduces aqueous outflow facility and may result in elevation of intraocular pressure (IOP), as seen in pigment dispersion syndrome, or in optic nerve damage associated with visual field loss, as seen in pigmentary glaucoma. Pigmentary glaucoma and PDS occur when pigment is released from the iris pigment epithelium due to rubbing of the posterior iris against the anterior lens zonules. The disease is more prevalent in males, and typically presents in the 3rd-4th decade of life.
significantly flatter corneas
more affected eye was noted to have more iris-lens contact than the less affected eye
greater iris concavity, more posterior iris insertion) were also more common in patients with PDS or PG.
collapse of trabecular sheets, free pigment granules and cellular debris clogging the intertrabecular spaces, and macrophages and degenerated trabecular endothelial cells filled with pigment.
Diagnosis
Visual symptoms are unusual except in patients with visual field loss.
intermittent IOP elevation
brought about by exercise or dark exposure
roughly 1/3 of patients demonstrated extensive anterior chamber pigment
pigment reversal sign,” where the trabecular meshwork is found to be darker in the superior quadrant when compared with the inferior quadrant.