BACKGROUND Pseudoexfoliation syndrome is an age-related systemic disease manifesting itself primarily in the eyes and is characterised by the accumulation of microscopic granular amyloid-like protein fibres. Pseudoexfoliation is the most commonly seen identifiable cause of secondary glaucoma. The significance is that, it has a more aggressive clinical course with higher IOP readings and is difficult to treat due to poor response to medications. Aim-To find out the distribution of PCI in patients with Pseudoexfoliation (PXF) and to find out whether PCI can be taken as a predictor for clinical open angle glaucoma (OAG) secondary to pseudoexfoliation.
MATERIALS AND METHODSOurs was a non-randomised, cross-sectional observational study conducted over a period of 6 months among 112 eyes of patients above 40 years of age with pseudoexfoliation. The eyes were categorised into the following 4 groups: Group 1-Pseudoexfoliation syndrome; Group 2 -Eyes with pseudoexfoliation with normal corrected IOP but with glaucomatous disc and visual field changes; Group 3 -Eyes with pseudoexfoliation with raised IOP, but with normal disc and visual field; Group 4 -Pseudoexfoliative glaucoma. All the statistical analysis was done using statistical software IBM SPSS Ver. 21.0 (Armonk, NY).
RESULTS49 eyes PXS as Group 1, 19 eyes in group 2, 16 eyes in group 3 and 28 eyes in Group 4. Kruskal-Wallis test was used to compare the IOP, CCT and PCI measurements between the groups -P value is <0.001 which is statistically significant. The mean, SD and range in non-glaucomatous and glaucomatous eyes were compared using Rank sum, Mann-Whitney U test -P value <0.001 is statistically significant. This study shows that PCI can differentiate between glaucomatous and non-glaucomatous eyes better than the IOP levels in eyes with Pseudoexfoliation. This can be highly helpful in PXS patients with high PCI, to have a close followup schedule and for early diagnosis and treatment of pseudoexfoliative glaucoma, so that further damage to optic nerve head can be prevented.
CONCLUSIONIncreased PCI values in PXG patients can more accurately indicate the severity of glaucoma.