Optic Nerve Head, Peripapillary and Macular Microvascular Characteristics in Patients With Unilateral Pseudoexfoliation Glaucoma

Abstract

Précis: In unilateral pseudoexfoliation glaucoma (PEXG), there may be decreased choroidal vascularity index (CVI), radial peripapillary capillary plexus’ perfusion and flow. CVI may also be reduced in fellow eyes, suggesting that PEXG is bilateral disease. Purpose: Evaluation of peripapillary and macular choroidal microvascularity and radial peripapillary capillary plexus (RPC) in both eyes with unilateral pseudoexfoliation glaucoma (PEXG) and healthy eyes. Materials and Methods: Ninety-six eyes of 48 patients with unilateral PEXG (PEX (+): 48 eyes with PEXG; PEX (−): 48 eyes without PEX) and the right eyes of 45 age- and sex-matched healthy controls were included in the study. Choroidal vascular index (CVI) was calculated on enhanced depth imaging optical coherence tomography (EDI-OCT) scans. RPC vascular layer were evaluated by OCT-Angiography (OCTA). Results: Macular CVI (mCVI), temporal and nasal peripapillary CVI (pCVI) was significantly decreased in the PEX (+) compared to the PEX (−) and control group (P<0.05 for all). While there was a significant difference between PEX (−) and the control group in terms of mCVI and temporal pCVI, there was no significant difference between the two groups in terms of nasal pCVI (P=0.008, P=0.036 and P=0.604, respectively). There was a significant difference in perfusion density (PD) and flux index (FI) between PEX (+) group, PEX (−) group and control group in all quadrants and average value (P<0.05 for all). Although the PD and FI values in all quadrants and average values of the PEX (−) group were lower than the control group, this difference was not significant. Conclusions: CVI in the macula and peripapillary region tends to decrease in eyes with PEXG. Similarly, PD and FI were lower in eyes with PEXG. Low mCVI and temporal pCVI can also be seen in eyes without PEX.