Comparison of pseudoexfoliation patients structurally and functionally in different glaucomatous stages

Abstract

Aim: to compare functional staging using perimetry with structural results using Hiedelberg Retinal Tomograph (HRT), in pseudoexfoliation (PXS) patients. Methods: 110 eyes of 55 patients with bilateral PXS, and 60 eyes for 60 patients with unilateral PXS, and 50 right eyes of age matched controls were studied. Each participant was studied using perimetry to test visual field, and HRT to study optic nerve head (ONH). The measured parameters were mean sensitivity (MS), mean defect (MD), mean retinal nerve fiber layer (RNFL) thickness and in six sectors around ONH. The tested eyes were categorized based on visual field results into non-glaucomatous PXS, early pseudoexfoliation glaucoma (PXG), moderate PXG and severe PXG. The RNFL thicknesses were compared between groups. Results: MS, MD results were (21.7 dB, 1.45dB in controls, 20.9 dB, 1.54dB in non-glaucomatous PXS, 19.4 dB, 4.1 dB in early PXG, 13.5 dB, 9.4 dB in moderate PXG, and 9.1 dB and 13.4 dB in severe PXG). With significant difference between groups except between non-glaucomatous PXS and controls. Mean RNFL thickness and of superotemporal, inferotemporal and temporal sectors were significantly different between non-glaucomatous PXS and controls. Mean RNFL thickness and of superotemporal and inferotemporal sectors were significantly different between early PXG and non-glaucomatous PXS. Mean RNFL thickness and of all sectors except nasally and temporally were significantly different between early and moderate PXG, and mean RNFL thickness and of all sectors were significantly different between moderate and severe PXG. Conclusion: There was a general agreement between visual field and RNFL thickness in glaucoma stages. however, RNFL thickness altered earlier in non-glaucomatous PXS.

Keywords: Pseudoexfoliation, visual field, HRT