Medical Hypothesis, Discovery & Innovation in Optometry

Abstract

Background: To evaluate the use of anterior segment images, obtained with an automatic refractometer, to identify early defects of the iris pigmented epithelium in patients with pigment dispersion syndrome or pigmentary glaucoma without observable alterations at slit lamp.

Methods: In this cross-sectional observational study, from January 2018 to December 2019, following verbal consent, we observed anterior segment infrared images of 1700 subjects looking routine ophthalmological examination using an automatic refractometer. We selected infrared images of subjects who fulfilled inclusion and exclusion criteria and looked for focal defect in the iris pigment epithelium. 

Results: Twenty patients with focal iris pigmented epithelial defect were identified, and none of them showed evident signs of pigment dispersion syndrome. An in-depth evaluation of ocular structures, including gonioscopy, demonstrated the presence of pigment dispersion syndrome in all patients with iris defects. In two patients with a previous diagnosis of pigmentary glaucoma, the infrared images were unremarkable, allowing a correct classification of the disease.

Conclusions: The use of infrared images obtained by an automatic refractometer could provide an early and easy identification of pigment dispersion syndrome in crowded ophthalmology clinics, yet, more -designed studies are necessary to confirm these preliminary findings.