Retinal pigment epithelial dysfunction in patients with pigment dispersionsyndrome - Implications for the theory of pathogenesis

Objective: To test the hypothesis that the retinal pigment epithelial/photo receptor complex is affected in patients with pigment dispersion syndrome a nd/or in patients with pigmentary glaucoma. Methods: Electro-oculograms were recorded from patients with pigment disper sion syndrome, pigmentary glaucoma, ocular hypertension, and primary open-a ngle glaucoma and from control subjects. Electro-oculograms were recorded d uring 15 minutes of dark adaptation followed by 15 minutes of light adaptat ion. For each subject, dark-trough amplitudes, dark-trough latencies, light -peak amplitudes, light-peak latencies, and ratios of the light-peak amplit ude to the dark-trough amplitude (Arden ratios) were calculated. Results: A 1-way analysis of variance of the Arden ratios indicated signifi cant differences among the groups of subjects. Results of a post hoc Newman -Keuls test revealed that the mean Arden ratios of patients with pigment di spersion syndrome and patients with pigmentary glaucoma were significantly lower than the mean ratios of the controls, the patients with primary open- angle glaucoma, and those,,vith ocular hypertension. Conclusions: The results provide support for the hypothesis that the integr ity of the retinal pigment epithelial/ photoreceptor complex is affected in patients with pigment dispersion syndrome and in those with pigmentary gla ucoma. Congenital and/or structural abnormalities of the retinal pigment ep ithelial/photoreceptor complex should be considered when models of the etio logy of pigment dispersion syndrome are proposed.