LONG-TERM PROGNOSIS OF PIGMENTARY GLAUCOMA

Outcome, prognosis and course of pigmentary glaucoma were studied in 38 patients (75 eyes). The mean age of the subjects at the time of diagnosis was 34.0 years and at the time of the study 44.1 years. The follow-up time ranged from 2 to 30 years with a mean follow-up time of 10.1 years. At the time of the study eighty-nine percent of the eyes had normal vision (0.7 or better), 3% slight impairment of vision (0.6-0.3), 5% low vision (0.2-0.05) and 3% were blind. Visual field defects were mild in 78%, moderate in 13% and severe in 8% of the eyes. One eye (1%) had normal fields. In 8 patients the stage of the field defects was asymmetrical between the two eyes. All were able to read at least monocularly with glasses. No one was blind, retired early or professionally limited because of pigmentary glaucoma. Thirty-nine eyes were on topical treatment. Fifteen eyes had additionally been treated with laser trabeculoplasty when the glaucoma could not be stabilized with topical treatment combined with systemic acetazolamide. Further twenty eyes had undergone trabeculectomy, 18 of them when medical treatment had failed and 2 following LTP. The non-involved eye of a patient suffering from a monocular disease was without treatment. The mean intraocular pressure at the time of the diagnosis was 33.5 mmHg (SD 10.4 mmHg) and at the final visit 17.5 mmHg (SD 3.4 mmHg). Four eyes were operated for cataracts and one for retinal detachment. The outcome of pigmentary glaucoma in this study was that two patients (5% of the patients) were visually impaired in a socio-economic sense because of field defects, one had cataract after trabeculectomy and one patient treated with pilocarpin for eight years had retinal detachment. One subject who had been treated with timolol for six years retired early due to asthma. The course and prognosis of pigmentary glaucoma seems to be quite favourable.