Evaluation Of Retinal Nerve Fibre Layer Thickness In Pseudoexfoliation Syndrome Using Spectral-Domain Optical Coherence Tomography.

Abstract

Background: Pseudoexfoliation syndrome (PXS) is a disorder characterized by the progressive accumulation of fibrillary extracellular deposits in several ocular tissues. It is an independent risk factor for glaucomatous optic nerve damage. Retinal nerve fiber layer (RNFL) thickness analysis using optical coherence tomography is a documented investigative tool to detect glaucoma early.

Objective: The aim was to evaluate and compare RNFL thickness in PEX patients without glaucoma with their age and sex-matched healthy controls and to detect the possibility of early glaucomatous damage in patients with RNFL thinning.

Study Design: Prospective case-control study

Participants: Patients presenting in the Department of Ophthalmology from October 2017 to April 2019

Materials and Methods: A total of 100 patients were included, of which 50 were cases (Group A) and 50 were controls (Group B). RNFL thickness of cases and controls were compared using Zeiss Cirrus HD-OCT 500.

Results: There were no significant differences between the two groups with respect to mean RFNL thickness in inferior (p = 0.002) , nasal (p = 0.129) and temporal quadrants (p = 0.925) . The mean thickness of retinal nerve fibre layer in superior quadrant in Group A was 101.6 ± 23.16 μm whereas in group B it was 113.5 ± 13.47 μm. (p< 0.001) . The average RFNL thickness Group A was 85.1 ± 13.99 μm and in Group B it was 88.9± 7.01 μm. (p = 0.017) .

Conclusion: There was statistically significant difference in RNFL thickness between cases and controls in inferior and superior quadrants and in global average thickness.

Implications: HD-OCT is a very reliable investigative tool to measure RNFL thickness, which helps in detecting preperimetric glaucoma.