The Role of Dynamic Ultrasound Biomicroscopy in Defining Laser Treatment in Pigment Dispersion Syndrome/ Pigmentary Glaucoma. A Case Series
Background: To assess utility of Dynamic UBM (in light & dark room illuminations) in deciding laser Iridotomy in Pigment Dispersion Syndrome(PDS)/Pigmentary Glaucoma (PG)
Method: Prospective interventional cohort study. Eyes with PDS/PG underwent UBM under light & dark by same operator. Presence of Iris Concavity(IC), Iridolenticular Contact(ILC), Iridozonular Contact(IZC) & Irido-Ciliary Process Contact(ICC) were quantified & LASER Iridotomy was advised. Post-LASER, UBM was redone at 4-6 weeks & later.
Results: UBM was done in 10 eyes of 6 pts with PDS/PG. 4 eyes (40%-group 1) had IC under light with ILC. In 6 eyes (60%; group2) UBM was redone under dark, picking up IC in 5 eyes (50%). In group 2,5 eyes had ILC (1 eye each with IZC & ICC also).8 of the advised 9 eyes underwent Nd-YAG PI. 6(75%) eyes showed reversal of reverse pupillary block at mean follow up of 11.33wks.
Conclusion: UBM in different room illuminations can be useful in deciding LASER treatment in PDS/PG to restore normal iris configuration.
2. Ritch R. Pigment dispersion syndrome. Am J Ophthalmol 1998; 126:442–5.
3. Migliazzo CV, Shaffer RN, Nykin R, et al. Long-term analysis of pigmentary dispersion syndrome and pigmentary glaucoma. Ophthalmology 1986; 93:1528–36.
4. Farrar SM, Shields MB,Miller KN, et al. Risk factors for the development and severity of glaucoma in the pigment dispersion syndrome. Am J Ophthalmol 1989;108:223–9
5. Siddiqui Y, Ten Hulzen RD, Cameron JD, et al. What is the risk of developing pigmentary glaucoma from pigment dispersion syndrome? Am J Ophthalmol 2003; 135:794–9.
6. P Mora, C Sangermani, S Ghirardini, A Carta, N Ungaro, SA Gandolfi; Ultrasound biomicroscopy and iris pigment dispersion: a case―control study; Br J Ophthalmol 2010; 94:428-432.
7. Sokol J, Stegman Z, Liebmann JM, et al. Location of the iris insertion in pigment dispersion syndrome. Ophthalmology 1996;103:289–93.
8. Karickhoff JR. Reverse pupillary block in pigmentary glaucoma: follow up and new developments. Ophthalmic Surg. 1993;24:562–3.
9. Pavlin CJ, Harasiewicz K, Foster FS. Posterior iris bowing in pigmentary dispersion syndrome caused by accommodation Am J Ophthalmol 1994; 118;114–16.
10. Strouthidis NG, Scott A, Peter NM, et al. Optic disc and visual field progression in ocular hypertensive subjects: detection rate, specificity and agreement. Invest Ophthalmol Vis Sci 2006; 47:2904–10.
11. Potash SD, Tello C,Liebmann J, Ritch R(1994) Ultrasound biomicroscopy in pigment dispersion syndrome. Ophthalmology 101:332–339.]
12. Karickhoff J R (1992) Pigmentary dispersion syndrome and pigmentary glaucoma: a new mechanism concept, a new treatment and a new technique. Ophthalmic Surg23:269–277.
13. Roberto G Carassa, Paolo Bettin, Marina Fiori, Rosario Brancato;Nd:YAG laser iridotomy in pigment dispersion syndrome: an ultrasound biomicroscopic study; Br J Ophthalmol1998;82:150-153.