Glaucoma pseudoexfoliativo. Reporte de un caso

Abstract

Pseudoexfoliative glaucoma (GP) is a chronic progressive optic neuropathy by the presence of grayish fibrillar material in the anterior segment of the eye. The clinical picture varies and may include elevated intraocular pressure (IOP) due to aqueous humor blockage, cataract, visual field loss, optic nerve damage and phacodonesis. The GP can have genetic, environmental, or dietary origins.

Case report: Male patient, 69 years old, has a history of hypertension and hypercholesterolemia, and has undergone cataract surgery in both eyes. GP was made based on the patient’s physical examination, which revealed the presence of pseudoexfoliative material in intraocular lenses and the pupillary border. The Intraocular Pressure (IOP) in the right eye was measured at 25 mmHg and 26 mmHg in the left eye. Complementary examinations, such as visual field study, optic nerve photography, and optical coherence tomography (OCT), confirmed the diagnosis. Finally, the treatment involved pharmacological and surgical interventions. A Selective Laser Trabeculoplasty (SLT) was performed in both eyes, using1M mJ energy, to facilitate the drainage of the aqueous humor, and, therefore, reduce the IOP. After three months of SLT and therapy with a triple hypotensive combination, the patient’s tonometry results were as follows: Right Eye: 12 mmHg, Left Eye: 11 mmHg. These results indicate a favorable therapeutic. The patient has reported fewer symptoms and shown compliance and promising therapeutic adherence. SLT should be considered as a therapeutic alternative.