Comparison of retinal and choroidal vascular changes via OCTA between Pseudoexfoliative glaucoma and Pseudoexfoliative syndrome without glaucoma and control group

Abstract

Due to the association of retinal vascular changes with PEX and the very limited number of available studies comparing this condition with PEX patients before the onset of glaucoma and on the other hand, due to the relatively high prevalence of this disease; this study aimed to determine the differences in retinal and choroidal vascular changes using OCTA in patients with pseudoexfoliative glaucoma and patients with pseudoexfoliation syndrome without glaucoma and the control group. Materials and Methods: In this cross-sectional study, all patients with pseudoexfoliative glaucoma and pseudoexfoliation syndrome without glaucoma were referred to the clinics of Tabriz Nikukari Hospital. The control group was selected from patients referred to the same clinics. All patients in all three study groups underwent OCTA, performed using the Optovue device. In the 6*6 mm images of the macular center, the vascular structures of the macular region were examined as FAZ area, superficial and deep capillary plexus density, flow area and non-flow area indices in all three groups. Results: The vascular density of superficial and deep capillary retinal networks significantly decreased in Fovea, Para-Fovea and PEX patients with and without glaucoma compared to controls. However, no statistically significant difference was observed between the two groups. In addition, FAZ levels were increased in PEX patients with and without glaucoma compared with controls. Regarding the flow area, it was observed that only in the outer retina, the values of the flow area in patients of control group were significantly higher than the PEX and PEX Glaucoma groups; But no difference was observed between the PEX and PEX Glaucoma groups. Also, the mean of fovea retinal thickness in patients with PEX with glaucoma was significantly reduced compared to the control group. RNFL thickness evaluation showed that RNFL levels were significantly higher in patients with PEX without glaucoma than PEX with glaucoma, but there was no statistically significant difference compared with the control group. In addition, this variable was significantly lower in PEX patients without glaucoma compared to the control group.