Analysis of Retinal Nerve Fiber Layer Thickness in Patients with Pseudoexfoliation Syndrome Using Optical Coherence Tomography

Abstract

Objective: To evaluate the retinal nerve fiber layer (RNFL) thickness in patients with unilateral pseudoexfoliation syndrome (PXS) without glaucoma by using optical coherence tomography (OCT). Methods: 22 patients with unilateral PXS were evaluated. Group 1 included the eyes with the pseudoexfoliation, group 2 included the fellow eyes; 18 age-matched normal control eyes were assessed in group 3. The mean and segmental RNFL thickness in eyes with pseudoexfoliation and their fellow eyes in patients with unilateral PXS was compared to age-matched control subject eyes. Results: The RNFL in patients with PXS were significantly thinner than controls in all quadrants except the nasal quadrant with regard to segmental analysis (p < 0.05). This RNFL loss was apparent at 7, 10 and 11 o’clock of the PXS eyes with regard to clock hour position (p < 0.05). In the fellow eyes, no significant difference in RNFL measurement was found except the temporal quadrant when compared with the controls. In the analysis with regard to clock hour position, no significant reduction in RNFL thickness was found except in the 11-o’clock segment. In PXS eyes, RNFL thicknesses at the inferior quadrant and the 1-, 2- and 5-o’clock segments were significantly lower than in non-PXS eyes (p < 0.05). Conclusions: This study suggests that PXS without glaucoma may be associated with a thinner RNFL compared with those of age-matched control subjects and non-PXS fellow eyes. Further studies are needed to clarify the relationship between the decrease in RNFL thickness and the development of glaucomatous damage in eyes with pseudoexfoliation.

Retinal Nerve Fiber Layer Thickness Changes in the Pseudoexfoliation Syndrome: A Meta-Analysis of Case-Control Studies

“…Three studies were performed in Turkey [10,12,22] , and one each was performed in Cairo [11] , Pakistan [6] Iran [13] India [7] , and Greece [21] . The mean age of the patients in each study ranged from 54 to 71 years, and the percentage of men ranged from 25 to 94%.…”

“…In addition, the results of studies using optical coherence tomography (OCT) to compare RNFL thickness in 4 quadrants between PXS patients and healthy controls have been inconsistent. While it has been reported that the RNFL in patients with PXS is significantly thinner than in controls in all quadrants except the nasal quadrant [10,11] , other studies have reported that RNFL thickness is reduced only in the inferior quadrant [6,12] . Additionally, one study found that the average thickness of all quadrants was significantly lower than in controls, but there was no significant reduction when quadrants were looked at individually [13] .…”

Evaluation of the anterior chamber angle in pseudoexfoliation syndrome

“…Many researchers have also observed a statistically significantly higher IOP in patients with PEX compared to the control group. 2,3,15,17,18 Klemetti et al pointed out that the initial average IOP in eyes with PEX is important in the conversion from PEX to PEXG. They noticed that the eyes with PEX which developed ocular hypertension or glaucoma later in the course of disease had had a significantly higher IOP (p < 0.001) compared to the eyes in which there was no development of glaucoma.…”

Analysis of Retinal Nerve Fiber Layer Thickness in Patients with Pseudoexfoliation Syndrome Using Spectral Domain Optical Coherence Tomography

“…Yüksel et al (4) . assessed the RNFL thickness in patients with unilateral PXS without glaucoma and their normal fellow eyes using Stratus OCT-3.…”