Study Results
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Basic Information
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COMPLETED
118 participants
OBSERVATIONAL
2025-05-01
2026-01-30
Brief Summary
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Detailed Description
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This syndrome manifests itself with flaking at the pupillary margin and anterior lens capsule, increased pigmentation in the trabecular meshwork, and open-angle glaucoma. In PES, extracellular matrix deposits, exfoliative material, and amyloid accumulations have been demonstrated in other organs as well. Relationships between PES and systemic diseases such as diabetes mellitus, ischemic heart diseases, cerebrovascular diseases, and hypertension have been reported.
PES, defined as a neurodegenerative disease, has also been reported to be associated with Alzheimer's disease. It has been reported that PES affects peripheral nerves and has a direct relationship with carpal tunnel syndrome (CTS).
CTS is a condition resulting from compression of the median nerve in the carpal tunnel at the wrist and is the most common entrapment neuropathy. CTS is most commonly seen in the 3rd-5th decades and is three times more common in women than men. Most cases are idiopathic where the cause cannot be determined. While repetitive trauma is most commonly blamed in the etiology, some systemic diseases, primarily obesity, diabetes mellitus (DM), and rheumatoid arthritis (RA), are reported to play a role.
High body mass index (BMI) is an important risk factor in the development of CTS. A positive correlation between BMI and CTS severity has been reported. It has been found that CTS is more common and more severe in patients with metabolic syndrome, an endocrinopathy characterized by abdominal obesity, atherogenic dyslipidemia, high blood pressure, insulin resistance or glucose intolerance, and prothrombotic and proinflammatory states. Dyslipidemia encountered in metabolic syndrome is characterized by high triglycerides and low HDL. Dyslipidemia is reported to make a significant contribution to peripheral nerve deterioration.
Dyslipidemia has also been reported in PES patients. Although a specific pathogenesis in PES is still unknown, hypoxia, ischemia, chronic inflammation, oxidative stress, and decreased cellular defense are emphasized. In PES, increased homocysteine levels along with decreased levels of vitamin B12 and folate, which are cofactors in homocysteine metabolism, have been reported. Study results regarding the relationship between vitamin B12 and CTS are contradictory.
Our aim in this study is to investigate the frequency of co-occurrence of PES and CTS. Literature information about the association of PES and CTS is limited. The purpose of this study is to make a new evaluation on this subject and contribute to the literature. Thus, we believe we can reach data that will lay the groundwork for more comprehensive future research focused on common pathophysiology for these two syndromes whose etiopathogenesis has not been fully elucidated.
Conditions
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Study Design
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CASE_CONTROL
PROSPECTIVE
Study Groups
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Control Group
Control group will be selected from among patients who present to physical therapy outpatient clinics with complaints such as mechanical back, knee, or hip pain, without any symptoms or findings suggestive of CTS, and matched for age and sex ratio. Patients who will constitute the control group will also be informed about the study, and detailed informed consent will be obtained from those who agree to participate. Subsequently, EMG examination will be performed on the same day to evaluate the presence of CTS.
No interventions assigned to this group
Pseudoexfoliation Group
Patients will be selected from among those diagnosed with Pseudoexfoliation Syndrome (PES). Patients who are diagnosed with PES during routine eye examination will be informed about the study, and if they agree to participate, detailed informed consent will be obtained. EMG will be performed on the same day for consenting patients to evaluate whether they have Carpal Tunnel Syndrome (CTS).
No interventions assigned to this group
Eligibility Criteria
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Inclusion Criteria
* Having been diagnosed with PES during routine eye examination
Exclusion Criteria
* Acromegaly
* Presence of any structural abnormality in bone structure
* Pregnancy
* Diabetes mellitus
* Gout
* Rheumatoid arthritis
* Connective tissue disease
* Acromegaly
* Thoracic outlet syndrome
* Brachial plexopathy
* Cervical disc herniation
* Presence of cardiac pacemaker
* Steroid users
* Thyroid disease
* Repetitive hand operations
18 Years
90 Years
ALL
Yes
Sponsors
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Ankara Training and Research Hospital
OTHER
Responsible Party
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Nadide Koca
Physical Medicine & Rehabilitation Specialist
Locations
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Department of Physical Therapy and Rehabilitation, University of Health Sciences, Ankara Training and Research Hospital
Ankara, Altindag, Turkey (Türkiye)
Countries
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References
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Tarim B. The role of serum biomarkers in determining systemic inflammation and cardiovascular risk in pseudoexfoliation syndrome. Int Ophthalmol. 2024 Dec 19;45(1):15. doi: 10.1007/s10792-024-03382-5.
Otelea MR, Nartea R, Popescu FG, Covaleov A, Mitoiu BI, Nica AS. The Pathological Links between Adiposity and the Carpal Tunnel Syndrome. Curr Issues Mol Biol. 2022 Jun 8;44(6):2646-2663. doi: 10.3390/cimb44060181.
Malakootian M, Soveizi M, Gholipour A, Oveisee M. Pathophysiology, Diagnosis, Treatment, and Genetics of Carpal Tunnel Syndrome: A Review. Cell Mol Neurobiol. 2023 Jul;43(5):1817-1831. doi: 10.1007/s10571-022-01297-2. Epub 2022 Oct 10.
Shahriari M, Karimzadeh A, Esmaily H, Rezanejad S, Nikkhah H, Yadgari M, Pourhoseingholi A. Electrodiagnostic signs of carpal tunnel syndrome in ocular pseudoexfoliation syndrome. Int Ophthalmol. 2022 Sep;42(9):2749-2755. doi: 10.1007/s10792-022-02264-y. Epub 2022 Apr 27.
Padhy B, Alone DP. Is pseudoexfoliation glaucoma a neurodegenerative disorder? J Biosci. 2021;46:97.
Patil VR, Vallabha K, Wali K. Systemic Vascular Parameters in Ocular Pseudoexfoliation. Cureus. 2024 Jun 22;16(6):e62933. doi: 10.7759/cureus.62933. eCollection 2024 Jun.
Tomczyk-Socha M, Tomczak W, Winkler-Lach W, Turno-Krecicka A. Pseudoexfoliation Syndrome-Clinical Characteristics of Most Common Cause of Secondary Glaucoma. J Clin Med. 2023 May 21;12(10):3580. doi: 10.3390/jcm12103580.
Plateroti P, Plateroti AM, Abdolrahimzadeh S, Scuderi G. Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma: A Review of the Literature with Updates on Surgical Management. J Ophthalmol. 2015;2015:370371. doi: 10.1155/2015/370371. Epub 2015 Oct 29.
Other Identifiers
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AnkaraTRH-FTR-NK-05
Identifier Type: -
Identifier Source: org_study_id
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