Question 8: What other conditions are associated with anterior segment pigment deposition?

Question 8: What other conditions are associated with anterior segment pigment deposition?

 Answer:

Several conditions can mimic or contribute to anterior segment pigment deposition, potentially leading to misdiagnosis of PDF. It is crucial to differentiate these conditions from PDS to ensure appropriate management and prevent complications.

• Intraocular inflammatory conditions: Fuchs uveitis, herpetic uveitis, Posner-Schlossman syndrome, and Vogt-Koyanagi-Harada disease. A thorough history and clinical examination will differentiate anterior uveitis from pigment dispersion syndrome.
• Conditions causing iris depigmentation and atrophy: Horner syndrome, pseudoexfoliation syndrome, trauma, and acute angle-closure glaucoma. Patients presenting with pigment in the anterior chamber should be questioned about a history of intraocular surgery or trauma (blunt or penetrating).
• Other disorders that can resemble PDS: Ring melanoma of the iris and the anterior segment. Ultrasound biomicroscopy imaging analysis is crucial to distinguish ring melanoma of the anterior chamber from PG.

In patients with dense pigment but with absent clinical findings, secondary causes of pigment liberation need to be ruled out, especially to exclude uveal melanomas, a life-threatening disease.

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