Clinical presentation and initial treatment patterns in patients with exfoliation glaucoma versus primary open-angle glaucoma.

BACKGROUND AND
OBJECTIVE: The presentation and initial response to treatment of consecutive patients with exfoliation glaucoma (PXE) and primary open-angle glaucoma (POAG) were evaluated prospectively. PATIENTS AND METHODS: Forty-six consecutive newly diagnosed patients with POAG and PXE were included in a prospective study that evaluated the initial clinical course and treatment results. The two groups were age- and race-matched.
RESULTS: This study found no difference in optic disc parameters at presentation between patients with POAG (n = 22) and those with PXE (n = 24) (P > .05). However, the presenting mean defect was significantly worse in patients with PXE versus those with POAG (P = .0038), although the loss variance was similar (P > .90). The mean presenting intraocular pressure (IOP) for patients with PXE (32.0 +/- 5.2 mm Hg) was greater than that for patients with POAG (27.1 +/- 4.4 mm Hg) (P= .0025). Additionally, patients with PXE required more treatment steps to control IOP (P = .005). Thirteen of 24 patients with PXE versus 3 of 22 patients with POAG (P = .016) required either laser or conventional surgical techniques to reduce IOP.
CONCLUSION: This study shows that patients with PXE have greater visual field loss and have more difficulty gaining control of IOP on presentation than patients with POAG.