A Prospective Cross-Sectional Study Of Correlation Of Ocular Pseudoexfoliation With Systemic Vascular Diseases

Abstract

Background: Pseudoexfoliation syndrome [PEX] is characterized by a powdery substance in the anterior chamber, composed of various glycoproteins, which have an unclear origin. Its deposition is observed on the pupillary margin, lens zonules, and trabecular meshwork. Proteomic studies have identified numerous proteins in affected individuals, suggesting associations with systemic conditions like heart disease, stroke, and Alzheimer’s disease. However, the systemic associations of PEX remain inconclusive, particularly in regions like southern India. Materials and Methods: A cross-sectional study was conducted on 114 participants. Pseudoexfoliation was graded as mild, moderate and severe per a standard photographic grading. Systemic examinations included blood pressure measurements, electrocardiography, and blood investigations for serum lipid profile, fasting and postprandial blood sugar levels, and serum C-reactive protein levels. All the patients underwent small incision cataract surgery. Intraoperative complications and postoperative status were noted down. Results: Thirty-eight patients (33.3%) had mild PEX, 44 (38.6%) had moderate PEX, and 32 (28.1%) had severe PEX. Hypertension was present in 54 participants (47.4%), diabetes in 21 (18.4%), coronary artery disease in 9 (7.9%), and cerebrovascular accidents in 3 (2.6%). The mean systolic blood pressure was 140.39 mmHg, and the mean diastolic blood pressure was 90.37 mmHg. Systolic blood pressure exceeded 140 mmHg in 29 participants (90.6%) with severe PEX, while diastolic blood pressure surpassed 90 mmHg in 26 (81.3%) participants with severe PEX, with a p-value of 0.001. Mean fasting and postprandial blood sugar levels were 103.80 ± 31.81 mg/dl and 131.72 ± 48.24 mg/dl, respectively. Electrocardiographic results indicated that 54 participants (47.37%) had abnormal ECGs, including rate, conduction, ischemic, and structural defects. Of these, 13.2% had rate defects, 12.3% had conduction defects, 10.5% had ischemic changes, and 11.4% had structural defects. Conclusion: This study highlights the significantly elevated parameters of systemic vascular diseases in PEX patients, like elevated blood pressure and more frequent cardiac abnormalities, emphasizing the need for comprehensive systemic evaluation and careful preoperative assessments for ocular complications