Abstract
Purpose To evaluate the difference in macular choroidal thickness and volume between patients with pseudoexfoliative glaucoma (PXG), patients with pseudoexfoliative syndrome (PEX), and normal controls. Methods This case-control study included 49 PXG patients (group A), 33 PEX patients (group B), and 42 sex-, age-, and axial length-matched healthy volunteer eyes (group C). The macular choroidal thickness and volume of all subjects studied were measured by enhanced depth imaging optical coherence tomography. Results The average macular (AM) choroidal thickness was 170.79 ± 50.18 μm, 184.65 ± 57.54 μm, and 206.46 ± 48.90 μm, and the average volume was 0.52 ± 0.15 μm3, 0.56 ± 0.17 μm3, and 0.63 ± 0.15 μm3 in groups A, B, and C, respectively. The macular choroidal thickness, the volumes of various macular regions, and the average choroidal thickness and volume in group A were lower than those in group C (all P < 0.05). There were no significant differences in the macular choroidal thickness, volumes of various macular regions, or average choroidal thickness or volume between group A and B (all P > 0.05). The macular choroidal thickness and volume of the TIM and SOM in group B were lower than those in group C (P < 0.05). There was no association between the macular choroidal thickness of various macular regions and visual field mean defect (MD) in group A (all P > 0.05). Conclusion The macular choroidal thickness in patients with PXG or PEX (TIM and SOM) is thinner than that in normal subjects. The macular choroidal thickness in patients with PXG is not significantly different from that in patients with PEX. The role of macular choroidal thickness changes in the glaucomatous damage of patients with PXG is still unclear.
Highlights
Pseudoexfoliative glaucoma (PXG) is a secondary glaucoma caused by pseudoexfoliative syndrome (PEX), accounting for approximately 25% of cases of open-angle glaucoma [1]
After 10 years of follow-up, 38% of patients had progressed from monocular PEX to binocular PEX [10], 5.3% of PEX patients had progressed to PXG within 5 years, and 15.4% of PEX patients had progressed to PXG within 10 years [11]
PXG progresses rapidly, and drug treatment has a poor effect, which is why PEX develops into PXG [12]
Summary
Pseudoexfoliative glaucoma (PXG) is a secondary glaucoma caused by pseudoexfoliative syndrome (PEX), accounting for approximately 25% of cases of open-angle glaucoma [1]. Exfoliative substances and pigments are deposited in the trabecular meshwork, which obstructs Schlemm’s canal, resulting in the narrowing of the lumen and eventually causing the lumen wall to collapse, leading to the development of PXG [2]. PEX is an important and definitive risk factor for open-angle glaucoma. Under the same intraocular pressure, PEX eyes are more likely to develop glaucoma than non-PEX eyes [3]. Exfoliative material is deposited in the anterior segment tissues of the eyes, such as the corneal endothelium, lens surface, and trabecular meshwork, but may have an impact on the posterior segment tissues of the eyes such as posterior ciliary arteries, vortex veins, and central retinal vessels [4]. Some studies [5, 6] have found hemodynamic abnormalities in retrobulbar vessels in patients with PEX and PXG
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