Lecture 7 Pseudoexfoliation syndrome Flashcards
(T/F) Exfoliation syndrome (XFS) and pseudo-exfoliation syndrome are the same thing
True, also, it is caused from the capsular delamination of the lens
(T/F) XFS (exfoliation syndrome) is common in glass blowers
True bc there is no protection of infrared radiation
What is the origin of the pigment deposits found in XFS?
a) lens
b) corneal endothelium
c) iris
d) both a and c
d) both a and c (The precise origin is unknown–partly lens and iris)
Which one of the following is NOT where XFS pigment material is found?
a) lens epithelium and capsule
b) iris pigment epithelium, stroma and blood vessels
c) pupillary margin
d) macula
d) macula
Which TWO of the following is TRUE regarding XFS?
a) XFS is best detected when pt’s pupil is constricted so you can get a better view of the angle
b) XFS is better detected when pt’s pupil is dilated so you can get a better look at the lens
c) XFS is detected when looking at the corneal endothelium for krukenberg spindle pattern
d) XFS is detected with transillumination of the iris when looking for a moth-eaten appearance
b) XFS is better detected when pt’s pupil is dilated so you can get a better look at the lens (look for a clear zone of removal of material by iris movement)
d) XFS is detected with transillumination of the iris when looking for a moth-eaten appearance
remember krukenberg spindle is found in pigment dispersion syndrome
(T/F) XFS is a significant risk factor for XFG (exfoliation glaucoma), in fact, 30% of XFS pt’s develop XFG.
true
Which one of the following is NOT true regarding XFS?
a) incidence is greater in males than in females
b) when the pupil is dilated, an XFS pt will show a central disc that corresponds to the size of the pupil
c) when the pupil is dilated, an XFS pt will show a clear zone-removal of material by the iris
d) when the pupil is dilated, an XFS pt will show a peripheral granular zone due to undisturbed accumulation of material
a) incidence is greater in males than in females (false, the opposite is true, its greater in females)
(T/F) Prevalence of XFS is highest in Finland (21%) and prevalence of XFG is highest in Australia (14.2%)
true
In XFS, why would you find phacodonesis (vibration of the lens) and subluxation of the lens (displacement of the lens)?
Because XFS material contains proteolytic enzymes that cause dengenerative changes to the zonules
(T/F) Regarding pt’s with XFS, in prone (laying on stomach) position, anterior lens movement can occur causing pupillary block and increasing chances of angle closure
true
(T/F) Production of XFS material continues after cataract extraction
true and also may cause late decentration or even subluxation of lens implant
Which one of the following is NOT true in regards to XFS
a) iris trans-illumination defects show “moth-eaten” pattern
b) pupillary margin shows white flecks and loss of pigment and loss of “pupillary ruff”
c) The iris dilates better since parts of the iris are thinner
d) The TM shows heavy pigmentation grade 3 or 4
c) iris dilates better since parts of the iris are thinner (false-iris DOESN’T dilate as well in thinner areas because of iris sphincter and dilator muscles have undergone degenerative changes due to the proeolytic nature of the XFS material)
Which of the following is NOT true in regards to XFS?
a) Dispersion of melanin post pharmacological dilation may cause acute IOP rise, check IOP post dilation
b) gonioscopy shows even 360 degrees pigmentation
c) chamber is narrow due to fwd movement of lens-iris diaphragm
d) pigment deposition on Schwalbe’s line referred to as sampaolesi’s line
b) gonioscopy shows even 360 degrees pigmentation (false-shows uneven pigmentation)
Which one of the following is not an iris change seen with fluoroscein angiography in XFS pt’s?
a) neovascularization
b) hyperperfusion
c) both a and b
b) hyperperfusion (false-you will see HYPOperfusion. Why? bc vessels blocked with material cause hypoxia)
Which one of the following is NOT related to XFS?
a) increased IOP due to increased outflow resistance?
b) XFS material appears on corneal endothelium
c) specular microscopy of of corneal endothelium shows low cell density
d) Morphological changes are seen in the sclera
d) ) Morphological changes are seen in the sclera (false–there are morphological changes to the cornea)