DOI: 10.4103/pajo.pajo_41_26 ISSN: 2666-4909

Comparison of macular ganglion cell analysis, optic nerve head, and retinal nerve fiber layer thickness analysis by spectral domain optical coherence tomography in pseudoexfoliation syndrome, early pseudoexfoliative glaucoma, and normal subjects

R. Swati, Madhu Bagali
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Abstract

Purpose:

The purpose of the study was to compare macular ganglion cell analysis (GCA), optic nerve head (ONH) parameters, and retinal nerve fiber layer thickness (RNFL) analysis on spectral domain-optical coherence tomography (OCT) in pseudoexfoliation syndrome, early pseudoexfoliative glaucoma compared to normal subjects.

Secondary Objectives:

To compare the diagnostic ability of these OCT parameters to diagnose early pseudoexfoliative glaucoma. To compare the prevalence of pseudoexfoliation syndrome, early pseudoexfoliative glaucoma in patients with outdoor compared to indoor occupation.

Methods:

Forty-four normal subjects, 44 patients with pseudoexfoliation syndrome, and 47 patients with early pseudoexfoliative glaucoma were included in this prospective, cross-sectional study in a tertiary care hospital. OCT measurements-macular ganglion cell thickness – average, minimum, and in various quadrants; ONH parameters – rim area, disc area, rim/disc area, average, superior, and inferior NRR; RNFL thickness-superior and inferior were analyzed. Area under the receiver operating characteristic curve (AUROC) was performed to calculate the diagnostic accuracy to discriminate between pseudoexfoliation syndrome versus early pseudoexfoliative glaucoma.

Results:

All the above-mentioned OCT parameters were significantly different ( P = 0.001) among normal, pseudoexfoliation syndrome, and early pseudoexfoliative glaucoma groups. Diagnostic accuracy to discriminate between early pseudoexfoliative glaucoma versus pseudoexfoliation syndrome was found to be excellent for inferior RNFL, with highest AUROC 0.943; good for average RNFL (AUROC 0.891) and superior RNFL (AUROC 0.814), fair for rim area (AUROC 0.748), whereas other variables proved to be less impactful. Pseudoexfoliation syndrome and early pseudoexfoliation glaucoma groups were having more patients 28 (35.8%) and 25 (32.1%), respectively, with outdoor occupation.

Conclusion:

Regular follow-up of patients with pseudoexfoliation syndrome by documenting OCT glaucoma parameters to diagnose early pseudoexfoliative glaucoma is recommended.

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