Clinical Profile and Demographic Distribution of Pseudoexfoliation Syndrome: An Electronic Medical Record-driven Big Data Analytics from an Eye Care Network in India

Overview

Journal Indian J Ophthalmol

Specialty Ophthalmology

Date 2023 Jul 7

PMID 37417115

Authors

Gazella Bruce Warjri

Anthony Vipin Das

Sirisha Senthil

Affiliations

Soon will be listed here.

Abstract

Purpose: To describe the demographics and clinical profile of pseudoexfoliation syndrome (PXF or PES) in patients presenting to a multi-tier ophthalmology hospital network in India.

Methods: This cross-sectional hospital-based study included 3,082,727 new patients presenting between August 2010 and December 2021. Patients with a clinical diagnosis of PXF in at least one eye were included as cases. The data were collected using an electronic medical record system.

Results: Overall, 23,223 (0.75%) patients were diagnosed with PXF. The majority of the patients were male (67.08%) and had unilateral (60.96%) affliction. The most common age group at presentation was during the seventh decade of life with 9,495 (40.89%) patients. The overall prevalence was higher in patients from a lower socio-economic status (1.48%) presenting from the urban geography (0.84%) and in retired individuals (3.61%). The most common location of the PXF material was the pupillary margin (81.01%) followed by the iris (19.15%). The majority of the eyes had mild or no visual impairment (<20/70) in 12,962 (40.14%) eyes. PXF glaucoma was documented in 7,954 (24.63%) eyes. Krukenberg's spindle was found in 64 (0.20%) eyes, phacodonesis in 328 (1.02%) eyes, and lens subluxation in 299 (0.93%) eyes. Among the surgical interventions, cataract surgery was performed in 8,363 (25.9%) eyes, trabeculectomy was performed in 966 (2.99%) eyes, and a combined procedure in 822 (2.55%) eyes.

Conclusion: PXF more commonly affects males presenting during the seventh decade of life from lower socio-economic status and is predominantly unilateral. A quarter of the affected eyes are associated with glaucoma and the majority of the eyes have mild or no visual impairment.

Citing Articles

Prevalence of pseudoexfoliation among patients at the Kolar district's tertiary care teaching Institute.

Divija K, Nagaraj I Bioinformation. 2025; 20(9):1002-1006.

PMID: 39917215 PMC: 11795498. DOI: 10.6026/9732063002001002.

References

Colin J, Le Gall G, Le Jeune B, Cambrai M . The prevalence of exfoliation syndrome in different areas of France. Acta Ophthalmol Suppl (1985). 1988; 184:86-9. DOI: 10.1111/j.1755-3768.1988.tb02634.x. View

Mitchell P, Wang J, Smith W . Association of pseudoexfoliation syndrome with increased vascular risk. Am J Ophthalmol. 1997; 124(5):685-7. DOI: 10.1016/s0002-9394(14)70908-0. View

Schlotzer-Schrehardt U, Naumann G . Ocular and systemic pseudoexfoliation syndrome. Am J Ophthalmol. 2006; 141(5):921-937. DOI: 10.1016/j.ajo.2006.01.047. View

Freissler K, Kuchle M, Naumann G . Spontaneous dislocation of the lens in pseudoexfoliation syndrome. Arch Ophthalmol. 1995; 113(9):1095-6. DOI: 10.1001/archopht.1995.01100090017008. View

Rumelaitiene U, Zaliuniene D, Speckauskas M, Tamosiunas A, Radisauskas R, Juseviciute E . Link of ocular pseudoexfoliation syndrome and vascular system changes: results from 10-year follow-up study. Int Ophthalmol. 2020; 40(4):957-966. DOI: 10.1007/s10792-019-01262-x. View

AASVED H . Study of relatives of persons with fibrillopathia epitheliocapsularis (pseudoexfoliation of the lens capsule). Acta Ophthalmol (Copenh). 1975; 53(6):879-86. DOI: 10.1111/j.1755-3768.1975.tb00406.x. View

Asano N, Schlotzer-Schrehardt U, Naumann G . A histopathologic study of iris changes in pseudoexfoliation syndrome. Ophthalmology. 1995; 102(9):1279-90. View

Forsman E, Cantor R, Lu A, Eriksson A, Fellman J, Jarvela I . Exfoliation syndrome: prevalence and inheritance in a subisolate of the Finnish population. Acta Ophthalmol Scand. 2007; 85(5):500-7. DOI: 10.1111/j.1600-0420.2007.00978.x. View

Michalik A, Kaufman P . Medical Management of Glaucoma in Exfoliation Syndrome. J Glaucoma. 2018; 27 Suppl 1:S87-S90. DOI: 10.1097/IJG.0000000000000920. View

10.

Lucas A, Copati I, Sivori D, Ringvold A . Pseudoexfoliation syndrome in a 27-year-old patient: a case report. Arq Bras Oftalmol. 2021; 84(3):275-278. PMC: 11826784. DOI: 10.5935/0004-2749.20210041. View

11.

Batur M, Seven E, Tanrikulu M, Ekin S, Tekin S, Yasar T . Pulmonary functions in pseudoexfoliation syndrome. Clin Respir J. 2018; 12(7):2271-2276. DOI: 10.1111/crj.12903. View

12.

Conway R, Schlotzer-Schrehardt U, Kuchle M, Naumann G . Pseudoexfoliation syndrome: pathological manifestations of relevance to intraocular surgery. Clin Exp Ophthalmol. 2004; 32(2):199-210. DOI: 10.1111/j.1442-9071.2004.00806.x. View

13.

Vijaya L, Asokan R, Panday M, Choudhari N, Sathyamangalam R, Velumuri L . The Prevalence of Pseudoexfoliation and the Long-term Changes in Eyes With Pseudoexfoliation in a South Indian Population. J Glaucoma. 2015; 25(6):e596-602. DOI: 10.1097/IJG.0000000000000276. View

14.

Wishart P, Spaeth G, Poryzees E . Anterior chamber angle in the exfoliation syndrome. Br J Ophthalmol. 1985; 69(2):103-7. PMC: 1040534. DOI: 10.1136/bjo.69.2.103. View

15.

Grodum K, Heijl A, Bengtsson B . Risk of glaucoma in ocular hypertension with and without pseudoexfoliation. Ophthalmology. 2005; 112(3):386-90. DOI: 10.1016/j.ophtha.2004.09.024. View

16.

Rao V, Doctor M, Rao G . Prevalence and Prognosis of Pseudoexfoliation Glaucoma in Western India. Asia Pac J Ophthalmol (Phila). 2015; 4(2):121-7. DOI: 10.1097/APO.0b013e3182a0af43. View

17.

Tomita G, Puska P, Raitta C . Interocular differences in optic disc configuration in the unilateral exfoliation syndrome. Acta Ophthalmol (Copenh). 1994; 72(2):162-7. DOI: 10.1111/j.1755-3768.1994.tb05010.x. View

18.

Donthineni P, Kammari P, Shanbhag S, Singh V, Das A, Basu S . Incidence, demographics, types and risk factors of dry eye disease in India: Electronic medical records driven big data analytics report I. Ocul Surf. 2019; 17(2):250-256. DOI: 10.1016/j.jtos.2019.02.007. View

19.

Bikbov M, Zainullin R, Gilmanshin T, Kazakbaeva G, Yakupova D, Nuriev I . Prevalence and Associated Factors of Pseudoexfoliation in a Russian Population: The Ural Eye and Medical Study. Am J Ophthalmol. 2019; 210:158-166. DOI: 10.1016/j.ajo.2019.10.003. View

20.

Fontana H, Nouri-Mahdavi K, Caprioli J . Trabeculectomy with mitomycin C in pseudophakic patients with open-angle glaucoma: outcomes and risk factors for failure. Am J Ophthalmol. 2006; 141(4):652-9. DOI: 10.1016/j.ajo.2005.11.039. View