The High Prevalence of Narrow Angles and Angle Closure Glaucoma in Eyes with Exfoliation Syndrome

Abstract

Background: Exfoliation syndrome (ES) is characterised by deposition of flakes of fluffy material over the lens and iris, which is commonly associated with glaucoma, though in majority of the patients it is of open angle type but incidence of angle closure glaucoma is higher than general population. Objective: This study was aimed to establish the real association of narrow angles with exfoliation syndrome by comparing it with age related control group to rule out the confounding factor of increasing age for narrow angles. Patients and methods: This was a prospective study carried out among fifty patients above the age of 50 years, who were suffering from exfoliation syndrome. They were compared with another group of 50, age and sex matched patients without exfoliation. The anterior chamber angle configuration were compared between these two groups. In this study the severity of exfoliation were also studied in relation to narrowness of anterior chamber angle and severity was graded based on the extent of distribution of exfoliation. Results: The study found that there was a high (25%) prevalence of occludable angles (grade I, II) in patients with exfoliation syndrome as compared to control group without exfoliation (10%). Among these eyes with occludable angles, 3.2% had totally occluded angle with angle closure glaucoma. The prevalence of open angle glaucoma was (14.2%) and 3.2% eyes with ES had ocular hypertension. The prevalence of occludable angles increase with severity of exfoliation. Conclusion: So this study concludes that angle closure glaucoma and occludable angles are associated with ES apart from open angle glaucoma. The angle tends to be more occludable as the severity of pseudo exfoliation increases.