Evaluation of the Inner Macula Layers, Circumpapillary Retinal Nerve Fiber Layer, and Minimum Rim Width Thickness in Patients with Pseudoexfoliation Syndrome Without Glaucoma Compared to Controls.

Precis: Minimum Rim width (MRW) is thinner in patients with non-glaucomatous pseudoexfoliation syndrome (XFS) and may be the first parameter affected in these patients due to the vascular nature of this disease.

Purpose: To evaluate the macular inner layers, circumpapillary retinal nerve fiber layer (cp-RNFL), and MRW in non-glaucomatous XFS compared to healthy subjects.

Methods: In this prospective study, using Heidelberg Spectralis optical coherence tomography (OCT) with glaucoma module premium edition, 8×8 grids of macular inner layers were exported, and the global, superior, and inferior thicknesses were used. Also, on the deviation map, the elliptical annulus around the fovea, which was 4.8×4 mm in size, was analyzed. Moreover, both groups calculated cp-RNFL and MRW values in three superior and three inferior sectors.

Results: Thirty-two eyes of thirty-two subjects with clinically detected non-glaucomatous XFS and 30 right eyes of age-sex-matched healthy controls were included. No significant difference was found between the case and control groups concerning the intraocular pressure (IOP) (14.94±2.09 mmHg vs. 15.27±2.27, respectively, P value= 0.556). The MRW of the superotemporal segment (MRW-TS) was significantly thinner in the XFS group compared with the control ones (303.69±60.49 µm vs. 341.43±56.19 µm, P = 0.014). No significant differences were found in the other sectors of MRW, macular inner layers, and cp-RNFL thickness between the groups.

Conclusion: These findings indicate that the MRW, especially in the superotemporal sector, may show early eye damage in patients with non-glaucomatous XFS, and it may be used to detect the early stage of glaucoma in XFS.