Pigment dispersion syndrome and pigmentary glaucoma: short overview

Relevance Pigment dispersion syndrome (PDS) is a condition characterized by the release of pigment from the posterior pigment layer of the iris, deposited on various structures of the anterior segment of the eye [1]. The main cause of this condition is friction of the posterior surface of the iris against the anterior surface of the lens and its ligamentous apparatus. It is most common in young men with myopic refraction. Pigment dispersion syndrome is usually asymptomatic, but with significant physical exertion, especially associated with severe shaking, periods of transient blurred vision may be observed. Biomicroscopy may show the following changes: deposition of dispersed pigment on the corneal endothelium (Krukenberg spindle) and the anterior surface of the iris, transillumination and reverse profile of the iris; pronounced pigmentation of the structures of the drainage zone of the eye is visualized in the angle of the anterior chamber [2–4]. In the future, SPD can progress to pigment glaucoma, which without treatment leads to irreversible loss of visual functions. The standard treatment for pigment glaucoma in Russia is peripheral laser iridectomy to prevent reverse pupillary block and, as a result, reduce friction between the iris and the ligamentous apparatus. Laser treatment also includes selective laser trabeculoplasty. The hypotensive effect after this procedure varies in patients and can last for 24 months on average. Drug therapy begins with the use of prostaglandin analogues (first line). If laser and drug treatment are ineffective, surgical intervention is used [5]. Recently, microinvasive surgery using drainage devices has become of greatest interest. The prognosis for pigment glaucoma is ambiguous, depending on early diagnosis and the optimal treatment method. Conclusion Pigment dispersion syndrome and pigment glaucoma require close attention from specialists and timely diagnosis. Keywords: pigment dispersion syndrome; pigment glaucoma; selective laser trabeculoplasty; laser iridectomy