[Pseudoexfoliation syndrome as a cause of chronic glaucoma].

A clinical study of 70 ambulant and stationary patients showed that of 104 eyes with pseudoexfoliation (PE) syndrome there were 62 eyes (60%) with confirmed chronic glaucoma and 8 (8%) with suspected chronic glaucoma. This is a considerably higher percentage than would normally be expected in a comparable group with an average age of 75 years (between 50 and 95 years). The biomicroscopic picture reveals symptoms of dispersion glaucoma with pigment participation. Provoked through diagnostic mydriasis by means of 0.5% tropicamide HCl and 10% phenylephrine HCl, 44 (52%) of the 84 eyes tested showed a significant increase in intraocular pressure by greater than or equal to 4 mm Hg and 20 (24%) by greater than or equal to 10 mm Hg. A possible cause of the pressure increase, in each case with open chamber angle, is the observed dispersion of the PE material and the adhering pigment fragments. From this observation and from a comparison with existing literature, it is inferred that the PE layers are the result of a sedimentation which also takes place in the chamber angle and in the trabecular meshwork, causing, in a first stage, chronic secondary open-angle glaucoma. In a second stage, the sediments may become detached from their base and cause pressure peaks through acute obliteration of the trabecular meshwork. The lack of proof of an inflammatory, immunological, or hereditary origin of this disease where it frequently occurs in certain areas, leads to the hypothesis of an alimentary or toxic disorder.(ABSTRACT TRUNCATED AT 250 WORDS)