Patterns of pseudoexfoliation deposits and its relation to intraocular pressure and retinal nerve fiber layer defects

• Main Authors: Gargi Sathish, Ebitha Kalarikkal Elias
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: TNOA Journal of Ophthalmic Science and Research
• Subjects: intraocular pressure; pseudoexfoliation; retinal nerve fiber layer defects
• Online Access: http://www.tnoajosr.com/article.asp?issn=2589-4528;year=2018;volume=56;issue=3;spage=146;epage=149;aulast=Sathish
• ISSN: 2589-4528; 2589-4536

Aims: The aims were to study various patterns of pseudoexfoliation (PXF) deposits over anterior lens capsule and its relation with intraocular pressure (IOP) and peripapillary retinal nerve fiber layer (RNFL) defects. Settings and Design: A cross-sectional study was conducted in the outpatient department of a tertiary care center. Subjects and Methods: Newly detected cases of PXF not on any antiglaucoma medications were selected. Central corneal thickness-corrected IOP was recorded with applanation tonometry. The four patterns that were made out are– three ring pattern (3R), two ring with no central disc (2R), radial pigmentary (RP) with multiple radial lines and combined (CR) pattern. RNFL thickness with optical coherence tomography was recorded. Statistical Analysis Used: Frequency calculation and analysis were done using t-test and Chi-square test as applicable using SPSS software. Sensitivity, specificity, and diagnostic accuracy of ring pattern in detecting high IOP and RNFL defects were calculated. Results: Out of 40 eyes with PXF, 17 and 15 eyes had 3R and 2R patterns, respectively. When out of 32 eyes with ring pattern, 8 recorded IOP >20 mmHg and 18 had RNFL defect. Sensitivity, specificity, and diagnostic accuracy of ring pattern in detecting RNFL thinning were 56.25%, 100%, and 65%, respectively. Conclusions: PXF is a severe form of glaucoma, with about 45% having severe disc damage even at presentation. Detection of ring pattern mandates early treatment and follow-up even with borderline IOP. RP pattern also requires regular follow-up as progression to severe damage may occur with age.