Prevalence of Pseudoexfoliation Syndrome in an Isolated Island Population of Korea: The Woodo Study.

Purpose: To determine the prevalence and clinical characteristics of pseudoexfoliation syndrome (PXS) within Korean population living in Woodo Island.

Methods: Among the 625 residents aged 50 years or older, 305 residents (197 women and 108 men) participated in the study; a response rate of 48.8%. Participants filled out questionnaires on life style. Intraocular pressure and corneal endothelial cell function was measured. Both pupils were dilated. Fundus photographs and stereo disc photographs were taken. Vertical cup-to-disc ratio was determined. Pure tone audiometry threshold was measured at 0.5, 1, 2, 4, and 6 kHz of frequencies for each ear.

Results: The prevalence rate of PXS among Woodo Island residents older than 50 years significantly increased with age, from 1.0% [95% confidence interval (CI), 0%-2.8%] in participants aged 50 to 59 years to 23.3% (95% CI, 8.2%-38.5%) in those aged over 80 years (P<0.001). The prevalence of PXS showed no significant difference between men and women in all age groups. The age-standardized prevalence rate of PXS was 10.4% (95% CI, 8.0%-12.8%), with a rate of 9.4% (95% CI, 5.8%-13.1%) in men and 14.9% (95% CI, 11.3%-18.4%) in women. PXS did not show significant association with smoking, outdoor activity, and occupation, except alcohol consumption. PXS showed significant decrease in endothelial cell density. Pure tone audiometry test of PXS group revealed statistically significant decrease in 1, 2 kHz.

Conclusions: The prevalence of PXS was 10.4% in the 50 years and older age group, and tended to increase with age. Decrease in corneal endothelial function and selective hearing loss was correlated in PXE patients, supporting impairment of systemic endothelial function in PXE syndrome.