Research Summary

Search for molecular markers for pseudoexfoliation syndrome and pseudoexfoliation glaucoma-same disease or different

Being a true bred clinician, my interest in basic research of pseudoexfoliation , though had taken roots quite early in my career, finally got a chance and breakthrough only after my fellowship and my entry into LV Prasad Eye Institute which allows (and also compels) clinicians to pursue research. Pseudoexfolation syndrome (PXF) is an age related systemic disorder characterized by accumulation of exfoliative material in trabecular meshwork (TM) which may also cause raised intraocular pressure (IOP) and glaucoma (pseudoexfoliation glaucoma, PXG) leading to permanent blindness in 50-75% of cases. Yet, the proposed mechanisms do not explain the clinical diversity in phenotypes seen in this entity. We have recently characterized the clinical phenotypic features in different stages of the disease further highlighting that glaucoma onset is heralded by unique phenotypic features The varied clinical phenotypes of the disease and lack of association of the signature deposits with the development of glaucoma have prompted scientists to search for possible role of molecular mechanisms signaling TM apoptosis and glaucoma. Potential mechanisms of glaucoma elucidated include abnormal extracellular matrix (ECM) turnover with TGF-β being elevated in the immediate environment. Since studies have implicated TGFβ, studying its role in pseudoexfoliation glaucoma pathogenesis is worthwhile.

Figure Legend: Figure shows differences in clinical pattern of deposits in eyes with pseudoexfoliation which may result in glaucoma in some patients.