- Exfoliation syndrome (exfoliation syndrome, XFS) - causes and risk factors
- Exfoliation syndrome (exfoliation syndrome, XFS) - symptoms
- Exfoliation syndrome (exfoliation syndrome, XFS) - diagnosis
- Exfoliation syndrome (exfoliation syndrome, XFS) - treatment
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Exfoliation syndrome (exfoliation syndrome, XFS) is an eye disease in which there is an increase in intraocular pressure and the development of open-angle glaucoma. Its course is more severe and the prognosis is worse than for primary open-angle glaucoma. What are the causes and symptoms of exfoliation syndrome (exfoliation)? What is the treatment?
Exfoliation syndrome (exfoliation syndrome, XFS)is an age-related extracellular matrix disorder of the eye in which abnormal fibrous material is produced and deposited in the eye. As a consequence, the intraocular pressure increases and relatively severe open angle glaucoma develops (its course is more severe and the prognosis is worse than in the case of primary open angle glaucoma). Currently, the exfoliation syndrome is considered to be the most frequently identified cause of open-angle glaucoma. In addition, there is increasing evidence of an etiological relationship between XFS and cataracts and possibly RVO (retinal vein occlusion), i.e. obstruction of the venous vessel (or vessels) in the retina caused by a blood clot. Exfoliation syndrome is also associated with the ophthalmic ischemic syndrome.
Exfoliation syndrome (exfoliation syndrome, XFS) - causes and risk factors
It is suspected that the desquamation syndrome may be a systemic disorder that is initially associated with transient ischemic attacks, cerebrovascular disease (especially stroke), and cardiovascular disease (especially hypertension and myocardial infarction). Some researchers associate XFS with neurodegenerative diseases (especially Alzheimer's disease). However, more research is needed in this direction.
It has been suggested that free radicals and damage resulting from oxidative stress also play an important role in the disease process. In addition, genetic factors are also suspected to play a role. In 2007, scientists identified a gene - LOXL1 - which they believe is strongly associated with XFS but does not contribute to the development of the disease on its own. The identification of additional genetic factors that contribute to the exfoliation syndrome, as well as geographic and environmental factors, is a goal of future research.
In turn, age is considered the main risk factor for the occurrence of the exfoliation syndrome (the risk of developing the disease increases with age). Gender is also important (the disease is usually diagnosed in women over 40) and white race.
Exfoliation syndrome (exfoliation syndrome, XFS) - symptoms
The formation of open-angle glaucoma in exfoliation syndrome occurs in the same way as in primary open-angle glaucoma.
Inside the eye, the so-called aqueous humor, the task of which is to supply the eye with nutrients. When it fulfills its task, it flows out of the anterior chamber of the eye through the percolation angle (this is the structure responsible for this process). The balance between fluid production and its outflow determines the correct intraocular pressure.
If this angle is closed or the openings in it are clogged (eg by the above-mentioned fibrous material), the drainage of the liquid is impossible. Then the pressure inside the eye rises, which results in irreversible destruction of the nerve fibers of the retina and the blood vessels that nourish them, and the atrophy of the optic nerve. This can be seen as eye pain and reduced visual acuity. As a last resort, you will lose your eyesight.
Exfoliation syndrome (exfoliation syndrome, XFS) - diagnosis
The diagnosis is made on the basis of the slit lamp examination results (the pathological material is most visible at the border of the pupil of the eye).
Exfoliation syndrome (exfoliation syndrome, XFS) - treatment
The goal of treatment is to lower the intraocular pressure with antihypertensive drugs.
If open-angle glaucoma cannot be controlled with drug treatment, the next step is argon laser trabeculoplasty. It is a procedure that lowers the intraocular pressure due to the creation of delicate laser focuses in the trabecular region.
Surgical filtration is the last resort.