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Pseudoexfoliation in a rural population of southern India: the Aravind Comprehensive Eye Survey.

Abstract

PURPOSE

To determine the prevalence and risk factors for pseudoexfoliation in a rural population of southern India.

DESIGN

A population-based cross-sectional study of pseudoexfoliation with and without glaucoma in rural southern India.

METHOD

A total of 5,150 subjects aged 40 years and older from 50 clusters representative of three southern districts of Tamil Nadu in southern India.

RESULTS

All participants had a comprehensive eye examination at the base hospital, including visual acuity using logarithm of minimal angle of resolution (logMAR) illiterate E charts and refraction, slit-lamp biomicroscopy, gonioscopy, applanation tonometry, dilated fundus examinations, and automated central 24-2 full-threshold perimetry. Pseudoexfoliation (PXF) was diagnosed by the presence of typical white deposits on the anterior lens surface; additional sites included the cornea, iris, anterior vitreous face, posterior capsule, and intraocular lens in cataract-operated eyes and changes in the angle determined through gonioscopy, including increased pigmentation, PXF deposition, and PXF material within the angle.

CONCLUSIONS

The prevalence (95% confidence interval) of PXF was 6.0% (5.3, 6.6). The prevalence increased with age (P <.001) and was greater in males (P =.01). Of subjects with PXF, 25.7% remained bilaterally blind after best correction; 89.3% of this bilateral blindness was the result of cataracts. The prevalence of glaucoma among subjects with PXF was 7.5%; exfoliation was present in 26.7% of those identified as primary open-angle glaucoma. On multivariate analysis, increasing age and male gender were significantly associated with PXF. Pseudoexfoliation appears to be a relatively common disorder in older individuals in southern India. Ophthalmologists in India may wish to focus on the detection of PXF, especially considering the relatively large burden of cataracts in this population, the risks for operative complications related to PXF, and the fact that PXF may be used as a marker to aid in the detectection of glaucoma.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Aravind Eye Care System and Lions-Aravind Institute for Community Ophthalmology, Madurai, Tamilnadu, India.

    , , , , , ,

    Source

    American journal of ophthalmology 135:6 2003 Jun pg 830-7

    MeSH

    Adult
    Age Distribution
    Aged
    Cross-Sectional Studies
    Exfoliation Syndrome
    Female
    Glaucoma
    Health Surveys
    Humans
    India
    Intraocular Pressure
    Male
    Middle Aged
    Prevalence
    Risk Factors
    Rural Population
    Sex Distribution

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    12788123

    Citation

    Krishnadas, R, et al. "Pseudoexfoliation in a Rural Population of Southern India: the Aravind Comprehensive Eye Survey." American Journal of Ophthalmology, vol. 135, no. 6, 2003, pp. 830-7.
    Krishnadas R, Nirmalan PK, Ramakrishnan R, et al. Pseudoexfoliation in a rural population of southern India: the Aravind Comprehensive Eye Survey. Am J Ophthalmol. 2003;135(6):830-7.
    Krishnadas, R., Nirmalan, P. K., Ramakrishnan, R., Thulasiraj, R. D., Katz, J., Tielsch, J. M., ... Robin, A. L. (2003). Pseudoexfoliation in a rural population of southern India: the Aravind Comprehensive Eye Survey. American Journal of Ophthalmology, 135(6), pp. 830-7.
    Krishnadas R, et al. Pseudoexfoliation in a Rural Population of Southern India: the Aravind Comprehensive Eye Survey. Am J Ophthalmol. 2003;135(6):830-7. PubMed PMID: 12788123.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Pseudoexfoliation in a rural population of southern India: the Aravind Comprehensive Eye Survey. AU - Krishnadas,R, AU - Nirmalan,Praveen K, AU - Ramakrishnan,R, AU - Thulasiraj,R D, AU - Katz,Joanne, AU - Tielsch,James M, AU - Friedman,David S, AU - Robin,Alan L, PY - 2003/6/6/pubmed PY - 2003/6/18/medline PY - 2003/6/6/entrez SP - 830 EP - 7 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 135 IS - 6 N2 - PURPOSE: To determine the prevalence and risk factors for pseudoexfoliation in a rural population of southern India. DESIGN: A population-based cross-sectional study of pseudoexfoliation with and without glaucoma in rural southern India. METHOD: A total of 5,150 subjects aged 40 years and older from 50 clusters representative of three southern districts of Tamil Nadu in southern India. RESULTS: All participants had a comprehensive eye examination at the base hospital, including visual acuity using logarithm of minimal angle of resolution (logMAR) illiterate E charts and refraction, slit-lamp biomicroscopy, gonioscopy, applanation tonometry, dilated fundus examinations, and automated central 24-2 full-threshold perimetry. Pseudoexfoliation (PXF) was diagnosed by the presence of typical white deposits on the anterior lens surface; additional sites included the cornea, iris, anterior vitreous face, posterior capsule, and intraocular lens in cataract-operated eyes and changes in the angle determined through gonioscopy, including increased pigmentation, PXF deposition, and PXF material within the angle. CONCLUSIONS: The prevalence (95% confidence interval) of PXF was 6.0% (5.3, 6.6). The prevalence increased with age (P <.001) and was greater in males (P =.01). Of subjects with PXF, 25.7% remained bilaterally blind after best correction; 89.3% of this bilateral blindness was the result of cataracts. The prevalence of glaucoma among subjects with PXF was 7.5%; exfoliation was present in 26.7% of those identified as primary open-angle glaucoma. On multivariate analysis, increasing age and male gender were significantly associated with PXF. Pseudoexfoliation appears to be a relatively common disorder in older individuals in southern India. Ophthalmologists in India may wish to focus on the detection of PXF, especially considering the relatively large burden of cataracts in this population, the risks for operative complications related to PXF, and the fact that PXF may be used as a marker to aid in the detectection of glaucoma. SN - 0002-9394 UR - https://www.unboundmedicine.com/medline/citation/12788123/Pseudoexfoliation_in_a_rural_population_of_southern_India:_the_Aravind_Comprehensive_Eye_Survey_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002939402022717 DB - PRIME DP - Unbound Medicine ER -