Optic Disk Appearance in Pseudoexfoliation Syndrome

Abstract

To evaluate the optic disk appearance in eyes with pseudoexfoliation syndrome. Clinical data and color stereo optic disk photographs of 99 patients with pseudoexfoliative glaucoma and 42 nonglaucomatous subjects with pseudoexfoliation syndrome were compared with those of 658 patients with primary open-angle glaucoma and of 364 normal subjects. Mean optic disk area was significantly (P = .009) smaller in the pseudoexfoliative glaucomatous eyes (mean +/-SD, 2.52 +/- 0.49 mm2) than in the primary open-angle glaucoma eyes (2.71 +/- 0.63 mm2). Correspondingly, mean optic disk area was significantly (P = .04) smaller in the pseudoexfoliative nonglaucomatous eyes (2.48 +/- 0.52 mm2) compared with the normal eyes without pseudoexfoliation (2.67 +/- 0.67 mm2). Comparing the pseudoexfoliative subgroups with the nonpseudoexfoliative subgroups separately in the glaucomatous and the nonglaucomatous groups, no significant differences were found for neuroretinal rim area, size of alpha and beta zones of the parapapillary atrophy, and diameters of the retinal arterioles and venules at the disk border. In the glaucomatous group, the maximal intraocular pressure measurements were significantly (P < .001) higher in the pseudoexfoliative subgroup than in the subgroup with primary open-angle glaucoma. Except for a slightly smaller optic disk, eyes with pseudoexfoliative glaucoma and eyes with primary open-angle glaucoma do not vary significantly in their optic disk appearance despite significantly higher intraocular pressure peaks in pseudoexfoliative glaucoma. In eyes with pseudoexfoliation syndrome, a small optic disk does not predispose to glaucoma. In contrast with the anterior segment of the eye, the optic disk does not show pathognomonic features for pseudoexfoliation.