On the classification of pigmentary glaucoma
https://doi.org/10.53432/2078-4104-2025-24-4-37-44
Abstract
In this article, the authors attempt to answer the question of which classification form (primary or secondary open-angle) should be assigned to pigmentary glaucoma, which is a clinical stage that completes the progressive course of pigment dispersion syndrome (PDS). The article presents risk factors, pathogenetic mechanisms, and clinical manifestations of PDS at successive stages of its development and briefly discusses the issue of pigmentary glaucoma prevention. Based on literature data and the authors’ own research, the evidence strongly supports the secondary nature of pigmentary glaucoma and the need to revise current classification schemes.
About the Authors
T. N. Iureva
Irkutsk Branch of S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery"; Irkutsk State Medical Academy of Postgraduate Education – Branch of Russian Medical Academy of Continuing Professional Education; Irkutsk State Medical University
Russian Federation
Russian Federation
Dr. Sci. (Med.), Professor, ophthalmologist, Deputy Director for Scientific Work, Professor at the Academic Department of Ophthalmology, Professor at the Academic Department of Eye Diseases
337 Lermontov St., Irkutsk, Russian Federation, 664033
100 Yubileyny mikrorayon, Irkutsk, Russian Federation, 664049
1 Krasnogo Vosstania St., Irkutsk,, 664003
A. G. Shchuko
Irkutsk Branch of S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery"; Irkutsk State Medical Academy of Postgraduate Education – Branch of Russian Medical Academy of Continuing Professional Education; Irkutsk State Medical University
Russian Federation
Russian Federation
Dr. Sci. (Med.), Professor, Director, Head of the Academic Department of Ophthalmology, Head of the Academic Department of Eye Diseases
337 Lermontov St., Irkutsk, Russian Federation, 664033
100 Yubileyny mikrorayon, Irkutsk, Russian Federation, 664049
1 Krasnogo Vosstania St., Irkutsk,, 664003
References
1. Nesterov A.P., Bunin A.Ya. On the new classification of primary glaucoma. Russian Annals of Ophthalmology 1977; 5:38-42.
2. Nesterov A.P., Egorov E.A. Classification of Glaucoma. Clinical Ophthalmology 2001; 2(2):35-37.
3. European Glaucoma Society Terminology and Guidelines for Glaucoma, 5th Edition. British Journal of Ophthalmology 2021; 105; 1-169. https://doi.org/10.1136/BJOPHTHALMOL-2021-EGSGUIDELINES
4. Kiuchi, Y., Inoue, T., Shoji, N. et al. The Japan Glaucoma Society guidelines for glaucoma 5th edition. Jpn J Ophthalmol 2023; 67; 189-254. https://doi.org/10.1007/s10384-022-00970-9
5. Krukenberg F. Beiderseitigeangeborene melanse der hornhaut. Klin Monatsbl Augenbeilkd 1899; 37:254-258.
6. Levinsohon G. Beitrag zurnpathologisch e anatomie und pathologie des glaukoms. Arch Augenbeilkd 1909; 62:131.
7. Sugar H.S., Barbour F.A. Pigmentary glaucoma: a rare clinical entitу. Am J Ophthalmol 1949; 32:90-92.
8. Sugar H.S. Pigmentary glaucoma: a 25-year review. Am J Ophthalmol 1966; 62:499-507.
9. Liebmann J.M., Tello C., Chew S.J., Cohen H., Ritch R. Prevention of blinking alters iris configuration in pigment dispersion syndrome and in normal eyes. Ophthalmology 1995; 102:446-455. https://doi.org/10.1016/s0161-6420(95)31001-9.
10. Campbell D.G., David G. Pigmentary Dispersion and Glaucoma. Archives of Ophthalmol 1979; 97(9):1667.
11. Karickhoff J.R. Pigmentary dispersion syndrome and pigmentary glaucoma: a new mechanism concept, a new treatment, and a new technique. Ophthalmic Surg 1992; 23:269-277.
12. Campbell D.G., Schertzer R.M. Pathophysiology of pigment dispersion syndrome and pigmentary glaucoma. Curr Opin Ophthalmol 1995; 6(2):96-101. https://doi.org/10.1097/00055735-199504000-00015.
13. Kupfer C., Kuwabara T., Kaiser-Kupfer M. The histopathology of pigmentary dispersion syndrome with glaucoma. Am J Ophthalmol 1975; 80:857-886. https://doi.org/10.1016/0002-9394(75)90283-4.
14. Gottanka J., Johnson D.H., Grehn F. Histologic Findings in Pigment Dispersion Syndrome and Pigmentary Glaucoma. Journal of Glaucoma 2006; 15(2):142-151. https://doi.org/10.1097/00061198-200604000-00011.
15. Richardson T.M., Hutchinson B.T. Grant WM. The outflow tract in pigmentary glaucoma: a light and electron microscopic study. Arch Ophthalmol 1977; 95:1015-1025. https://doi.org/10.1001/archopht.1977.04450060101010.
16. Alvarado J.A., Murphy C.G. Outflow obstruction in pigmentary and primary open angle glaucoma. Arch Ophthalmol 1992; 110:1769-1778. https://doi.org/10.1001/archopht.1992.01080240109042.
17. Kuchle M., Vinores S.A., Mahlow J., et al. Blood-aqueous barrier in pseudoexfoliation syndrome: evaluation by immunohistochemical staining of endogenous albumin. Br J Ophthalmol 1998; 82:1429-1432. https://doi.org/10.1007/BF00186513.
18. Epstein D.L. Pigment dispersion and pigmentary glaucoma. In: Chandler PA, Grant WM (eds) glaucoma. Lea & Febiger, Philadelphia, 1979. Рp. 122–131.
19. Richter C.U., Richardson T.M., Grant W.M. Pigmentary dispersion syndrome and pigmentary glaucoma: a prospective study of the natural history. Arch Ophthalmol 1986; 104:211-215. https://doi.org/10.1001/archopht.1986.01050140065021.
20. Scuderi G., Contestabile M.T., Scuderi L., Librando A., Fenicia V., Rahimi S. Pigment dispersion syndrome and pigmentary glaucoma: a review and update. Int Ophthalmol 2019; 39(7):1651-1662. https://doi.org/10.1007/s10792-018-0938-7.
21. Niyadurupula N., Broadway D.C. Pigment dispersion syndrome and pigmentary glaucoma — a major review. Clin Exp Ophthalmol 2008; 38:868-882. https://doi.org/10.1111/j.1442-9071.2009.01920.x.
22. Berger A., Ritch R., McDermott J., Wang R.F. Pigmentary dispersion,
23. refraction and glaucoma. Invest Ophthalmol Vis Sci 1987; 28:134.
24. Klingenstein A., Kernt M., Seidensticker F., et al. Anterior-segment morphology and corneal biomechanical characteristics in pigmentary glaucoma. Clin Ophthalmol 2014; 8:119126. https://doi.org/10.2147/OPTH.S53088.
25. Pavlin C.J., Macken P., Trope G.E., Harasiewics K., Foster F.S. Accomodation and iridotomy in the pigment dispersion syndrome. Ophthalmic Surg Lasers 1996; 27:113-120.
26. Yurieva T.N. Patterns of formation and development of a pathogenetically substantiated principle of treatment for pigment dispersion syndrome. Cand. Med. Sci. dissertation. Irkutsk, 1999. 140 p.
27. Shchuko A.G., Yurieva T.N., Chekmareva L.T., and Malyshev V.V. Patent RU 2215500 C2. Method for Determining the Stages of Development of Pigment Dispersion Syndrome of the Eye. 10.11.2003. Application No. 2001127963/14, filed on 16.10.2001.
28. Shchuko A.G., Yurieva T.N. Pigment dispersion syndrome. Part 1. Patterns of formation, substantiation of clinical classification. Glaucoma. Journal of the Research Institute of Glaucoma of the Russian Academy of Medical Sciences 2012; 4:39-45.
29. Scott A., Kotecha A., Bunce C., et al. YAG laser peripheral iridotomy for the prevention of pigment dispersion glaucoma. A prospective, randomized, controlled trial. Ophthalmology 2011; 118:468-473. https://doi.org/10.1016/j.ophtha.2010.07.026.
30. Shchuko A.G., Yurieva T.N. Pigment dispersion syndrome (PDS). Part 2. Pathogenetic substantiation and evaluation of the effectiveness of laser iridectomy in PDS. Glaucoma. Journal of the Research Institute of Glaucoma of the Russian Academy of Medical Sciences 2013; 2:47-52.
31. Shchuko A.G. et al. Rare Forms of Glaucoma. Irkutsk, PR-Studio, 2002. Pp. 104-133.
32. Gandolfi S.A., Ungaro N., Tadini M.G, et al. A 10 year follow-up to determine the effect of YAG laser iridotomy on the natural history of pigment dispersion syndrome: a randomized clinical trial. JAMA Ophthalmol 2014; 132:1433-1438. https://doi.org/10.1001/jamaophthalmol.2014.3291.
33. Michelassi M., Lindsley K. Peripheral iridotomy for pigmentary glaucoma. Cochrane Database Syst Rev 2016; 2(2):CD005655. https://doi.org/10.1002/14651858.CD005655.pub2.
Review
For citations:
Iureva T.N., Shchuko A.G. On the classification of pigmentary glaucoma. National Journal glaucoma. 2025;24(4):37-44. (In Russ.) https://doi.org/10.53432/2078-4104-2025-24-4-37-44
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