Pigment Dispersion Syndrome

Zusammenfassung Das Pigmentdispersionssyndrom ist eine Erkrankung, die durch Abschilferung von Pigment aus dem Irispigmentepithel und dessen Ablagerung im vorderen Augenabschnitt charakterisiert ist. Typisch ist eine Trias aus Ablagerungen am Hornhautendothel, zirkularen Iristransilluminationen und einer Pigmentierung des Trabekelwerks. Das Spektrum reicht vom einfachen Pigmentdispersionssyndrom bis zum Pigmentdispersionsglaukom mit Optikusatrophie. Abstract Pigment dispersion syndrome (PDS) is a disorder predominantly affecting young, myopic adults. It is characterised by the liberation of pigment of the iris and deposition of it on various structures of the anterior segment leading to multiple specific findings in slit lamp examination. Typical alterations are a deposition of pigment on the central corneal endothelium, circular iris transillumination defects in the mid periphery, a posterior bowing of the iris and increased pigmentation of the trabecular meshwork. Findings are usually bilateral symmetric. Posterior bowing of the iris causes rubbing of the pigmented iris epithelium against lens structures like zonular fibres with a consecutive liberation of pigment. Trabecular meshwork changes because of pigment deposition reduce aqueous outflow facility with the risk of elevated intraocular pressure and glaucoma. Pigmentary glaucoma (PG) is a secondary open angle glaucoma. Treatment of PG is similar to primary open angle glaucoma, including medical therapy, laser therapy and surgery. Peripheral laser iridotomy was shown to change iris configuration but its efficacy in the prevention of PG has not been confirmed in the literature. The purpose of this paper is to summarize information regarding ocular manifestations of PDS to facilitate an early diagnosis and to present a general view of the treatment of PG.