Frequency of Exfoliation Syndrome Among Patients Attending an Ophthalmology Outpatient Clinic in the Northeastern Black Sea Coast of Turkey.

Background

Exfoliation syndrome (XFS) is a common age-related disorder and a major risk factor for glaucoma and cataract. This study describes the hospital-based frequency and clinical associations of XFS among patients aged 40 years and older attending a regional ophthalmology outpatient clinic in the Northeastern Black Sea coastal region of Turkey.

Methods

This cross-sectional observational study included 938 eligible participants aged ≥40 years with registered birth records and continuous residence within the defined catchment area who underwent a comprehensive ophthalmological examination. XFS was defined by characteristic exfoliative material at the pupillary margin and/or on the anterior lens capsule (phakic eyes) or capsular bag/IOL complex (pseudophakic eyes), with pupillary assessment before and after pharmacologic dilation. Systemic comorbidities were extracted from national medical records. Multivariable logistic regression adjusted for age and gender.

Results

XFS was diagnosed in 20.8% (195/938; 95% CI: 18.2-23.5%). The XFS-positive (XFS+) group was older than the XFS-negative (XFS-) group (71.76 ± 0.61 vs. 63.25 ± 0.40 years; p < 0.001). Hypertension was more common in XFS+ participants (57.4% vs. 45.6%; p: 0.002) and remained associated after adjustment (OR: 1.49; 95% CI: 1.05-2.11; p: 0.024). Glaucoma was more frequent in XFS+ participants (23.6% vs. 14.9%; p: 0.005); it remained associated after adjustment (OR: 2.00; CI: 1.31-3.05; p: 0.001).

Conclusions

In this hospital-based surveillance, approximately one in five clinic attendees aged ≥40 years had XFS. Findings should not be extrapolated to population prevalence; population-based studies are required to estimate regional prevalence accurately. Nonetheless, these data highlight a substantial clinical burden of XFS in a regional care-seeking population and support vigilant glaucoma surveillance in affected patients.