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      An Iconic Case of Pigmentary Glaucoma: Brief Review of the Literature

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          Abstract

          Pigment dispersion syndrome and pigmentary glaucoma are two conditions characterized by pigment dispersion originating from the posterior part of the iris and its accumulation on the trabecular meshwork, corneal endothelium, and anterior surface of the lens. The pigment on the trabecular meshwork can cause chronic inflammation with a secondary reduction of its function and an increase in intraocular pressure. The case presented represents a typical example of pigmentary glaucoma in a myopic patient in which all the signs, symptoms, and complications typical of these pathologies were present. We report and describe an 8-year-long follow-up period with clinical and instrumental examinations.

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          Most cited references 16

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          Pigment dispersion syndrome and pigmentary glaucoma--a major review.

          Pigment dispersion syndrome (PDS) is an interesting condition that can lead to secondary open angle glaucoma. Pigmentary glaucoma is primarily a disease of young people, myopes and men. PDS is characterized by the presence of Krukenberg spindles, iris trans-illumination defects, trabecular meshwork pigmentation and backward bowing of the iris. Posterior bowing of the iris causes rubbing of the pigmented iris epithelium against lens structures, liberation of pigment and trabecular meshwork changes that result in reduced aqueous outflow with the risk of glaucoma. Peripheral laser iridotomy can reverse backward bowing of the iris and may prevent progression of pigmentary glaucoma.
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            Standard automated perimetry and algorithms for monitoring glaucoma progression.

            Despite increasingly sophisticated techniques for the computerized analysis of the optic nerve and retinal nerve fiber layer, standard automated perimetry (SAP) is still the primary test for assessing functional damage in glaucoma. Most of the diseases affecting the visual field can be studied analyzing the central visual field with a fixed grid of points set at 6 degrees or at a variable density within central 30 degrees, using a III white target stimulus (program 30/2 or 24/2 Humphrey, G1/G2 or 30/2 Octopus). Although there is lack of a true gold standard for glaucoma, SAP results were the primary endpoint in most of the clinical trials in glaucoma. New thresholding strategies allowed a considerable reduction of examination time without substantial loss of accuracy. Moreover, recent findings on structure-function correlation in glaucoma validate the clinical role of this well-known and widespread method of examination.
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              Visual Acuity, and Macular and Peripapillary Thickness in High Myopia.

              To investigate best corrected visual acuity (BCVA), and choroidal and retinal thickness values between high myopes without myopic maculopathy and emmetropes.
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                Author and article information

                Journal
                COP
                COP
                10.1159/issn.1663-2699
                Case Reports in Ophthalmology
                S. Karger AG
                1663-2699
                2020
                May – August 2020
                20 July 2020
                : 11
                : 2
                : 377-384
                Affiliations
                Ophthalmology Unit, NESMOS Department, S. Andrea Hospital, Faculty of Medicine and Psychology, University of Rome “La Sapienza”, Rome, Italy
                Author notes
                *Mariachiara Di Pippo, Ophthalmology Unit, NESMOS Department, S. Andrea Hospital, Faculty of Medicine and Psychology, University of Rome Sapienza, Via di Grottarossa 1035, IT–00189 Rome (Italy), mariachiara.dipippo@gmail.com
                Article
                508605 PMC7443622 Case Rep Ophthalmol 2020;11:377–384
                10.1159/000508605
                PMC7443622
                32884553
                © 2020 The Author(s). Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 3, Pages: 8
                Categories
                Case Report

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