Early stadiation of pigmentary dispersion syndrome and long-term analysis of progression to pigmentary glaucoma

A retrospective longitudinal study of 140 eyes in 70 patients who were observed for a mean of 82.6 months was performed to detect the progression of pigmentary dispersion syndrome in pigmentary glaucoma and to identify the risk factors. On the basis of angle pigmentation, the distribution of pigment in the anterior segment, and the presence of ocular hypertension, all the eyes were classified in three stages. Twenty-eight (20%) of the eyes with an initial diagnosis of pigmentary dispersion syndrome had developed pigmentary glaucoma. The probability of a remaining pigmentary dispersion syndrome for up to 5 years after diagnosis was 89% for all the eyes, whereas for up to 10 years it was 72%, and after 15 years it was 57%. The mean age of the patients at the time of transition to pigmentary glaucoma was 38.9 years (males, 35.2; females, 45.4). Sex distribution showed that pigmentary glaucoma was more frequent in men (male:female ratio, 1.8:1). Myopia was greater in the eyes in which pigmentary glaucoma had developed (P, 0.02). A significant increase in the rate of progression was present in the eyes that had angle hyperpigmentation, pigment deposited on various surfaces of the anterior segment, and ocular hypertension (stage 2 of the stadiation)