Pseudoexfoliation in the Reykjavik Eye Study: 5‐year incidence and changes in related ophthalmological variables

Abstract

Abstract Purpose The objective of this study was to examine the 5‐year incidence of definite and possible pseudoexfoliations (PEX) in a randomized sample, and changes in related ophthalmological variables. Methods The Reykjavik Eye Study is a randomized population‐based study of 1045 persons 50 years and older. It included keratorefractometry, air puff tonometry, Scheimpflug photography of the anterior segment, fundus photograph, and slit‐lamp examination. 88% of survivors participated in the 5‐year follow‐up study. Results Incidence PEX was found in 3.5% of all right eyes. Females have a twofold risk of 5‐year incidence compared with males (p=0.05). Increasing age was also linked to the incidence of PEX by an average of 5% between the 10‐year age‐groups (p=0.022). 68%, of those right eyes that did not have PEX at baseline remained the same 5 years later, whereas 11% were deemed to have progressed to possible PEX and 2% had progressed to definite PEX. 47% of the right eyes diagnosed with possible PEX at baseline, were not found to have signs of PEX after 5 years. 21% continued to be diagnosed as possible PEX and 5% progressed to definite PEX. Five year incidence cases of PEX showed a significant increase in IOP (p=0.007). Cup/disc ratio increases for all participants, significantly more for those that already had PEX at baseline. Conclusion The diagnosis of definite PEX holds well over five years, but not possible PEX. The incidence of PEX increases with age, and is more common in females. The results indicate that the increase in IOP that usually accompanies PEX develops in the same period as the PEX changes become visible. The increase in cup/disc ratio seem to accelerate after the PEX changes have established and not before.