Question 7: What is the natural history of pigment dispersion syndrome?

Question 7: What is the natural history of pigment dispersion syndrome?

Answer:

Many patients with pigment dispersion syndrome will not develop pigmentary glaucoma over the course of their lifetime. The degree of pigment dispersion does not necessarily correlate with the development of glaucoma. Patients with pigment dispersion syndrome, normal IOP and an absence of glaucomatous optic disc changes should have regular (every 1-2 years) follow-up including clinical examination, IOP measurement, disc photographs, OCT and visual field assessment. Asymmetry between the eyes is common.

A number of reports have shown that pigment dispersion decreases with age, and IOP may stabilise. Additionally, several reports have indicated that Krukenberg’s spindle and trabecular pigment become less prominent with time. Some patients may be able to discontinue ocular antihypertensive therapy, however, others will require lifelong treatment.

In most normal individuals with pigmentation in the trabecular meshwork, the pigmentation is more marked in the inferior quadrant. However, in patients with pigment dispersion syndrome or pigmentary glaucoma, the pigmentation may be denser in the superior quadrant (pigment reversal). In the absence of other signs, this may indicate to the clinician that the patient has had previous episodes of active pigment dispersion.

End of answer