CLINICAL PRESENTATION AND INITIAL TREATMENT PATTERNS IN PATIENTS WITHEXFOLIATION GLAUCOMA VERSUS PRIMARY OPEN-ANGLE GLAUCOMA

BACKGROUND AND OBJECTIVE: The presentation and initial response to tre atment of consecutive patients with exfoliation glaucoma (PXE) and pri mary open-angle glaucoma (POAG) were evaluated prospectively. PATIENTS AND METHODS: Forty-six consecutive newly diagnosed patients with POAG and PXE were included in a prospective study that evaluated the initi al clinical course and treatment results. The two groups were age- and race-matched. RESULTS: This study found no difference in optic disc p arameters at presentation between patients with POAG (n = 22) and thos e with PXE (n = 24) (P > .05). However, the presenting mean defect was significantly worse in patients with PXE versus those with POAG (P = .0038), although the loss variance was similar (P > .90). The mean pre senting intraocular pressure (IOP) for patients with PXE (32.0 +/- 5.2 mm Hg) was greater than that for patients with POAG (27.1 +/- 4.4 mm Hg) (P = .0025). Additionally, patients with PXE required more treatme nt steps to control IOP (P = .005). Thirteen of 24 patients with PXE v ersus 3 of 22 patients with POAG (P = .016) required either laser or c onventional surgical techniques to reduce IOP. CONCLUSION: This study shows that patients with PXE have greater visual field loss and have m ore difficulty gaining control of IOP on presentation than patients wi th POAG.