Evaluation of lamina cribrosa in pseudoexfoliation syndrome using spectral-domain optical coherence tomography enhanced depth imaging

Purpose: To evaluate the features of the lamina cribrosa (LC) in pseudoexfoliation glaucoma (PXG) patients using enhanced depth imaging (EDI) of spectral-domain optical coherence tomography (SD OCT). The results were compared with those of patients with primary open-angle glaucoma (POAG).

Design: Cross-sectional study.

Participants: Patients with PXG (n = 21) and POAG (n = 35) matched for age and visual field mean deviation (VF MD).

Methods: Participants were imaged using SD OCT. Lamina cribrosa thickness (LT) and anterior lamina cribrosa depth (ALD) were determined at 3 areas (mid superior, center, and mid inferior) by 2 examiners using an EDI mode of the optic nerve head.

Main outcome measures: The LT and ALD were compared between PXG and POAG eyes.

Results: Mean ± standard deviation baseline untreated intraocular pressure was not significantly different between the 2 groups (PXG, 18.3 ± 8.2 mmHg; POAG, 15.3 ± 3.4 mmHg; P = 0.310). The mean VF MD was -12.7 ± 9.0 dB in the PXG group versus -11.6 ± 9.1 dB in the POAG group (P = 0.643). When compared with the POAG group, the PXG group demonstrated a significantly thinner LT in all 3 areas and a thinner mean LT (133.4 ± 14.5 μm in the POAG group vs. 121.3 ± 13.0 μm in the PXG group; P<0.001). Anterior lamina cribrosa depth did not demonstrate a significant difference in any of the 3 areas between both groups (mean ALD, 324.3 ± 91.9 μm in the POAG group vs. 358.7 ± 142.7 μm in the PXG group; P = 0.470). Of 21 eyes in the PXG group, 9 eyes demonstrated a unilateral clinical presentation. When we compared the PXG eyes and the apparently normal-looking fellow eyes of those 9 eyes, neither the LT nor ALD demonstrated a significant difference (P = 0.223 and P = 0.079, respectively).

Conclusions: Eyes with PXG demonstrate a thinner LC compared with POAG eyes at similar levels of glaucoma severity.

Financial disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.