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Exfoliation Syndrome Among Azerbaijani

Exfoliation Syndrome Among Azerbaijani The high prevalence of exfoliation syndrome (XFS) in Azerbaijan, noticed during a short-term international eye project, prompted the following prospective survey of the frequency of XFS in a subset of the Azerbaijani population. Heretofore, the prevalence of XFS in Azerbaijan has not been reported. During a 3-month period in 2001, all native Azerbaijani who received an ocular examination from 1 of 2 ophthalmologists (Z.A. and S.S.) at a major general eye clinic in Baku, Azerbaijan, were evaluated for XFS. Most of these patients sought care because of difficulty seeing due to uncorrected or inadequately corrected refractive errors and/or presbyopia. Patients were designated as having XFS if exfoliation material was apparent on the anterior lens capsule and/or at the pupillary border during routine postdilation biomicroscopy, done with patient consent. The youngest patient with XFS was aged 46 years. Thus, the following findings apply to all patients 46 years or older (n = 302 patients, 604 eyes). The mean age was 69.0 years (range, 46-89 years), and 43% were men. Exfoliation syndrome was apparent in 92 patients (30%), and 52% of those affected were men. The disease was bilateral in 48% of those affected (mean age, 72.4 years) and unilateral in 52% (mean age, 71.3 years). Table 1 shows the frequency distribution of XFS according to age. Glaucoma had been diagnosed previously in 74 individuals (25%), 59% of patients with XFS and 10% of those without XFS. View LargeDownload Frequency Distribution of Exfoliation Syndrome (XFS) According to Age in a Subset of the Azerbaijani Population Exfoliation syndrome occurs in many diverse areas of the world, although the prevalence varies depending on multiple factors, including geography, race, ethnicity, and age.1 The reported prevalence among individuals older than 60 years ranges from 0% among Eskimos2 to 38% among the Navajo of New Mexico.3 Thus, the population studied exhibited a relatively high prevalence of XFS: 32% of patients older than 60 years. The prevalence increases with age, 1 as was seen in this study. Bilateralism tends to occur in slightly older patients than does unilateralism, 1 although a significant age difference was not apparent in this study. Sex predilection is equivocal in the literature, 1 and no significant sex predilection was evident in this study. In summary, this study indicates that there is a high prevalence of XFS among elderly Azerbaijani in the population subset evaluated. However, this study incorporates self-selection bias, and a larger, population-based study is needed to accurately determine XFS prevalence among Azerbaijani. Nevertheless, it can be concluded that ophthalmologists should use a liberal index of suspicion for XFS and its implications when caring for individuals of Azerbaijani heritage. Exfoliation syndrome often goes undetected because of a low index of suspicion.1 However, this syndrome is important to diagnose because its zonulopathy, cyclopathy, iridopathy, trabeculopathy, and corneal endotheliopathy can lead to significant clinical problems, including cataract surgery complications and glaucoma. Corresponding author: Alice T. Gasch, MD, 4100 Cathedral Ave, No. 510, Washington, DC 20016. References 1. Ritch R Exfoliation syndrome. In:Ritch RShields MBKrupin Teds. The Glaucomas 22nd St Louis, Mo Mosby Year Book Inc1996;993- 1022Google Scholar 2. Forsius H Prevalence of pseudoexfoliation of the lens in Finns, Lapps, Icelanders, Eskimos, and Russians. Trans Ophthalmol Soc U K. 1979;99296- 298Google Scholar 3. Faulkner HW Pseudo-exfoliation of the lens among the Navajo Indians. Am J Ophthalmol. 1971;72206- 207Google Scholar http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Exfoliation Syndrome Among Azerbaijani

Abstract

The high prevalence of exfoliation syndrome (XFS) in Azerbaijan, noticed during a short-term international eye project, prompted the following prospective survey of the frequency of XFS in a subset of the Azerbaijani population. Heretofore, the prevalence of XFS in Azerbaijan has not been reported. During a 3-month period in 2001, all native Azerbaijani who received an ocular examination from 1 of 2 ophthalmologists (Z.A. and S.S.) at a major general eye clinic in Baku, Azerbaijan, were...
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Publisher
American Medical Association
Copyright
Copyright © 2003 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.121.6.920-a
Publisher site
See Article on Publisher Site

Abstract

The high prevalence of exfoliation syndrome (XFS) in Azerbaijan, noticed during a short-term international eye project, prompted the following prospective survey of the frequency of XFS in a subset of the Azerbaijani population. Heretofore, the prevalence of XFS in Azerbaijan has not been reported. During a 3-month period in 2001, all native Azerbaijani who received an ocular examination from 1 of 2 ophthalmologists (Z.A. and S.S.) at a major general eye clinic in Baku, Azerbaijan, were evaluated for XFS. Most of these patients sought care because of difficulty seeing due to uncorrected or inadequately corrected refractive errors and/or presbyopia. Patients were designated as having XFS if exfoliation material was apparent on the anterior lens capsule and/or at the pupillary border during routine postdilation biomicroscopy, done with patient consent. The youngest patient with XFS was aged 46 years. Thus, the following findings apply to all patients 46 years or older (n = 302 patients, 604 eyes). The mean age was 69.0 years (range, 46-89 years), and 43% were men. Exfoliation syndrome was apparent in 92 patients (30%), and 52% of those affected were men. The disease was bilateral in 48% of those affected (mean age, 72.4 years) and unilateral in 52% (mean age, 71.3 years). Table 1 shows the frequency distribution of XFS according to age. Glaucoma had been diagnosed previously in 74 individuals (25%), 59% of patients with XFS and 10% of those without XFS. View LargeDownload Frequency Distribution of Exfoliation Syndrome (XFS) According to Age in a Subset of the Azerbaijani Population Exfoliation syndrome occurs in many diverse areas of the world, although the prevalence varies depending on multiple factors, including geography, race, ethnicity, and age.1 The reported prevalence among individuals older than 60 years ranges from 0% among Eskimos2 to 38% among the Navajo of New Mexico.3 Thus, the population studied exhibited a relatively high prevalence of XFS: 32% of patients older than 60 years. The prevalence increases with age, 1 as was seen in this study. Bilateralism tends to occur in slightly older patients than does unilateralism, 1 although a significant age difference was not apparent in this study. Sex predilection is equivocal in the literature, 1 and no significant sex predilection was evident in this study. In summary, this study indicates that there is a high prevalence of XFS among elderly Azerbaijani in the population subset evaluated. However, this study incorporates self-selection bias, and a larger, population-based study is needed to accurately determine XFS prevalence among Azerbaijani. Nevertheless, it can be concluded that ophthalmologists should use a liberal index of suspicion for XFS and its implications when caring for individuals of Azerbaijani heritage. Exfoliation syndrome often goes undetected because of a low index of suspicion.1 However, this syndrome is important to diagnose because its zonulopathy, cyclopathy, iridopathy, trabeculopathy, and corneal endotheliopathy can lead to significant clinical problems, including cataract surgery complications and glaucoma. Corresponding author: Alice T. Gasch, MD, 4100 Cathedral Ave, No. 510, Washington, DC 20016. References 1. Ritch R Exfoliation syndrome. In:Ritch RShields MBKrupin Teds. The Glaucomas 22nd St Louis, Mo Mosby Year Book Inc1996;993- 1022Google Scholar 2. Forsius H Prevalence of pseudoexfoliation of the lens in Finns, Lapps, Icelanders, Eskimos, and Russians. Trans Ophthalmol Soc U K. 1979;99296- 298Google Scholar 3. Faulkner HW Pseudo-exfoliation of the lens among the Navajo Indians. Am J Ophthalmol. 1971;72206- 207Google Scholar

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Jun 1, 2003

Keywords: exfoliation syndrome

References