Prevalence and risk factors of pseudoexfoliation syndrome in institutionalized geriatric patients in Navarra

PURPOSE: To establish the prevalence of pseudoexfoliation syndrome (PSX) in an institutionalized geriatric population in Navarra. To study the risk factors for the development of this disease. MATERIAL AND METHODS: 268 nursing home residents were studied, with a mean age of 81 years. The presence of PSX material in the anterior segment was best appreciated by slit lamp after pupillary dilation. We assessed its association with 13 ocular factors and 14 systemic factors. RESULTS: We found 10.1% (27) of subjects with PSX, 19 cases were unilateral and 8 bilateral. The frequency detected in subjects from Navarra was 7.9% versus 21.2% in subjects from other regions (p=0.02), although the significance was lost after multivariant logistic regression. The PSX was 3.5 times more frequent in patients suffering heart failure (p=0.01). The PSX was associated with anti-glaucomatous treatment, which multiplies the risk by 3.2 times (p=0.02); patients affected with age-related geographic macular atrophy had a 2.6 fold increased frequency (p=0.03), both after adjusting for age remained significant. We did not find any association between the PSX and other systemic factors (systemic hypertension and diabetes mellitus) or ocular factors (senile arc and cataract). CONCLUSIONS: The prevalence of PSX syndrome seems to be lower in an institutionalized population in Navarra than in other Spanish regions. The correlation with heart failure and age-related geographic macular atrophy suggests the possibility of a vascular role. The epidemiological association with increased IOP is confirmed.