pigment dispersion syndrome (PDS)

Last edited 02/2022 and last reviewed 06/2022

Pigment dispersion syndrome (PDS)

• can lead to secondary open angle glaucoma
• is primarily a disease of young people, myopes and men
• characterized by the presence of Krukenberg spindles, iris trans-illumination defects, trabecular meshwork pigmentation and backward bowing of the iris (1)
  • the classic diagnostic triad consists of corneal endothelial pigmentation (Krukenberg spindle), radial mid-peripheral iris transillumination, and dense trabecular pigmentation (2)
  • posterior bowing of the iris causes rubbing of the pigmented iris epithelium against lens structures, liberation of pigment and trabecular meshwork changes that result in reduced aqueous outflow with the risk of glaucoma
  • peripheral laser iridotomy can reverse backward bowing of the iris and may prevent progression of pigmentary glaucoma.

Reference:

• Niyadurupola N, Broadway DC. Pigment dispersion syndrome and pigmentary glaucoma-a major review. Clinical & Experimental Ophthalmology. 2008 Dec;36(9):868-882. DOI: 10.1111/j.1442-9071.2009.01920.x. PMID: 19278484.
• Fine BS, Yanoff M, Sheie HG. Pigmentary "glaucoma":A histologic study. Trans Am Acad Ophthalmol Otolaryngol. 1974;7:314-25