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this is malika hook from the university of colorado and this is the third installment of one slide in five minutes and the topic today is pseudo-exfoliation pseudo exfoliation syndrome sometimes abbreviated as pxf or pex is a systemic syndrome that is age-related usually over the age of 50 and mostly over the age of 70 and involves ocular tissues with the gradual deposition of fibrillary material on the lens capsule zonules trabecular meshwork corneal endothelium iris and pupillary margin and other tissues the fibrillar material is thought to be due to abnormal turnover of the extracellular matrix in basement membranes the disease is typically bilateral and asymmetric with one eye sometimes not manifesting overt signs of disease until later in the follow-up period some studies have shown associations with cardiovascular disease including myocardial infarction stroke and high blood pressure the mauthane pupillary margin pattern in pxf is thought to be due to focal membrane disruption i