Details
Category: Volume 05 Issue 08 August 2017
Hits: 1631

Title: Is There an Association between Pseudoexfoliation and Sensorineural Hearing Loss? A Case Control Study

Authors: Dr Aamina Shah, Dr Rameez Ganie, Dr Athar Shah, Dr Sabia Rasid, Dr Imtiyaz Dar

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.91

Abstract

Purpose: The purpose of this study was to study the presence of sensorineural hearing loss (SNHL) in patients with pseudoexfoliation (PXF) syndrome and its correlation with other ophthalmic findings.

Methods: A total of 55 patients with PXF and 50 age-matched and sex-matched normal controls were subjected to complete ophthalmological and audiological evaluation. The degree of hearing loss was compared between the two groups and correlated with pseudoexfoliation glaucoma. The independent-student t test, chi –square test, Fischer exact test Z test were used for statistical analysis.

Results: A total of 77patients among 105 patients (73%) had sensorineural hearing loss with pseudoexfoliation patients accounting for 62% and controls for 38%. Among the pseudoexfoliation group, 7  had normal hearing threshold level, 42 had mild SNHL, 6 had severe SNHL, while in the control group 21 had normal hearing threshold levels, 26 had mild degree of SNHL, 2 had severe degree of SNHL and 1 patient had profound degree of SNHL. When the hearing thresholds in decibels were compared between the two groups at frequencies 250, 500, 1000 and 2000 Hz using pure tone audiometry, the difference was statistically significant at all frequencies. Further there was no significant difference between the hearing thresholds of patients that had pseudoexfoliation glaucoma and those that had pseudoexfoliation alone.

Conclusion: The prevalence and severity of SNHL increases in cases of PXF compared with age-matched controls. This is not affected by presence or absence of glaucoma. This confirms the systemic nature of the disease and may have an implication on the treatment of these patients with regards to communication during the treatment. Hence it may become important  to screen these patients for sensorineural hearing loss.

Keywords: Pseudoexfliation, sensorineural hearing loss, glaucoma.

References

  1. Altintas O, yuksel N, Karabas VL, Qaglar Y. Diurinal intraocular pressure elevation in pseudoexfoliation syndrome. Eur J Ophthal 2004; 14 : 495-500.
  2. Shakib M, Ashton N, Blach R: Electron microscopic study of pseudo exfoliation of the lens capsule. II. Iris and ciliary body.

Invest Ophthalmol 1965; 4:154.

  1. Ringvold A: Electron microscopy of thelimbal conjunctiva in eyes with pseudo exfoliation syndrome (PE syndrome). Virchows Archiv A Pathol Anat Histopathol (Berlin) 1972; 355:275.
  2. Speakman JS, Ghosh M: The conjunctiva in senile lens exfoliation. Ophthalmology 1976; 94:1757.
  3. Ringvold A: Electron microscopy of the wall of iris vessels in eyes with and without exfoliation syndrome (pseudoexf-oliation of the lens capsule). Virchows Archiv A Pathol Anat Histopathol (Berlin) 1969; 348:328.
  4. Ghosh M, Speakman JS: The iris in senile exfoliation of the lens. Can J Ophthalmol 1974; 9:289.
  5. Streeten BW, Dark AJ, Wallace RN, et al: Pseudoexfoliative fibrillopathy in the skin of patients with ocular pseudoexfoliation. Am J Ophthalmol 1990; 110:490.
  6. Schlötzer Schrehardt U, Küchle M, Naumann GOH: Electron microscopic identification of pseudoexfoliation material in extrabulbar tissue. Arch Ophthalmol 1991; 109:565.
  7. Schlötzer Schrehardt U, Koca MR, Naumann GOH, Volkholz H: Pseudoexf-oliation syndrome. Ocular manifestation of a systemic disorder? Arch Ophthalmol 1992; 110:1752.
  8. Streeten BW, Li ZY, Wallace RN, et al: Pseudoexfoliative fibrillopathy in visceral organs of a patient with pseudoexfoliation syndrome. Arch Ophthalmol 1992; 110:1757.
  9. Amari F, Umihira J, Nohara M, et al: Electron microscopic immunohistoch-emistry of ocular and extraocular pseudoexfoliative material. Exp Eye Res 1997; 65:51.
  10. Lindberg JGMD: Clinical studies ofdepigmentation of the pupillary margin and transillumination of the iris in cases of senile cataract and also in normal eyes ofthe aged [original in German]. Thesis, Diss Helsingfors, Finland, 1917.
  11. J. Lim, “Functional structure of the organ of Corti: a review,” Hearing Research, vol. 22, pp. 117–146, 1986.
  12. Guidelines for audiologic screening. American Speech Language Hearing, Association. c1997. Available at: http://www.asha.org. [Accessed 1 March 2013]
  13. The American Speech and Hearing Association 1997–2010, “Facts about hearing assessment,” www.asha.org/public/hearing/ testing/assess.htm
  14. Strenzke, D. Pauli-Magnus, A. Meyer, A. Brandt, H. Maier, and T. Moser, “Update on physiology and pathophys-iology of the inner ear: pathomechanisms of sensorineural hearing loss,” HNO, vol. 56, no. 1, pp. 27–36, 2008.
  15. Yazdani, A. Tousi, M. Pakravan, and A.-R. Faghihi, “Sensorineural Hearing Loss in Pseudoexfoliation Syndrome,” Ophthalmology, vol. 115, no. 3, pp. 425–429, 2008.
  16. Samarai V, Samarei R, Haghighi NN, Jalili E. Sensory-neural hearing loss in pseudoexfoliation syndrome. Int J Ophthalmol 2012; 5:393–6.

Corresponding Author

Dr Aamina Shah

GMC Srinagar