title: Ultrasound biomicroscopic classification of zonules in exfoliation syndrome.
abstract: OBJECTIVE
  Exfoliation changes in the zonules or ciliary processes may be the earliest clinical sign of the exfoliation syndrome (XFS). In the present study we investigated the usefulness of ultrasound biomicroscopy (UBM) for detecting the early changes of XFS in zonules.
  
  
  METHODS
  Both eyes of 11 patients with unilateral XFS and the unilateral eyes of 11 subjects without evidence of XFS were examined using UBM. The incidence of zonular changes was compared among the XFS-positive eyes of the patients, their contralateral XFS-negative eyes, and the healthy eyes of the subjects without XFS.
  
  
  RESULTS
  Using UBM, we could successfully describe the zonules in all UBM images of all subjects. In the four quadrants, the incidence of granular-type zonules was statistically different among the three groups: it was higher in XFP-positive eyes than in XFS-negative eyes, and it was higher in XFS-negative eyes than in healthy eyes.
  
  
  CONCLUSIONS
  UBM can detect the zonular changes that may occur early in XFS. A granular-type change in the zonules may be the most typical finding in the presence of exfoliation material. Diagnostic criteria are proposed for the early detection of XFS, based on the changes found in the zonules by UBM.
authors.affiliation: Department of Ophthalmology, Gifu University School of Medicine, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Inazumi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takahashi
authors.forename: Toru
authors.initials: T
authors.lastname: Taniguchi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D000869:Anterior Eye Segment / Q000000981:diagnostic imaging; D017889:Exfoliation Syndrome / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D014463:Ultrasonography