CORRELATION OF PSEUDOEXFOLIATIVE MATERIAL AND OPTIC-NERVE DAMAGE IN PSEUDOEXFOLIATION SYNDROME

Purpose. To determine whether the severity of glaucomatous damage in e yes with pseudoexfoliative (PEX) glaucoma is related to the amount of PEX material in the trabecular meshwork. Methods. Trabecular meshwork and optic nerves from 19 eyes (11 donors) with PEX syndrome were studi ed. Eyes were chosen to represent all stages of severity of disease, S ections from each quadrant around the circumference of each eye were s tudied with light and transmission electron microscopy. Morphometric m easurements were made of Schlemm's canal (SC) and of the components of the cribriform region and were statistically correlated with axonal c ounts of the optic nerves. Correlations between clinical and histologi c data were determined. Results. Pseudoexfoliative material was freque ntly found in isolated aggregates beneath the inner-wall endothelium o f SC. The cribriform region was otherwise normal in structure; disorga nization of this region was found only in focal regions of a few eyes. The amount of PEX material was correlated with the maximal intraocula r pressure (IOP) and the IOP on treatment and was inversely correlated with the number of axons in the optic nerve. The number of axons was inversely correlated with the maximal IOP and the IOP on treatment, bu t not with duration of disease. Conclusions. The severity of glaucoma in PEX is related to the amount of PEX material present in the cribrif orm region. Elevation of IOP occurs before disorganization of the crib riform region and may be related to the location of the PEX material n ear the inner wall of SC. Comparison of clinical and histologic findin gs revealed that the results of visual field examinations fit more clo sely with the axonal counts than did the clinical assessment of the cu p-to-disc ratio.