Evaluation of Retinal Layers in Individuals with Pseudoexfoliation Syndrome and Ocular Hypertension

Abstract

Purpose: To analyze the thickness of the peripapillary retinal nerve fiber layer (RNFL) and eight macular layers using optical coherence tomography (OCT) in eyes with ocular hypertension (OHT) and pseudoexfoliation syndrome (PXS) and healthy eyes and to evaluate between-group differences. Materials and Methods: In a prospective study, the macular segmentation of retinal layers in 120 eyes of 120 participants was performed automatically using current Heidelberg Spectralis OCT software, which provides measurements for eight retinal layers. Thickness maps divided into nine subfields (i.e., 1, 3, and 6 mm) were extracted from the software for each retinal layer and compared between groups. Results: The thinnest macular layers appeared in the ocular hypertensive PXS, normotensive PXS, and OHT groups, in that order. In the inner retinal layers (macular retinal nerve fiber layer, ganglion cell layer, inner plexiform layer), statistically significant differences emerged between the PXS and control groups in all quadrants of the 3 and 6 mm areas. No significant difference between the OHT group and control group appeared except in the 6 mm temporal quadrant of the inner plexiform layer (IPL). Receiving operating characteristic (ROC) analysis revealed quadrants with high area-under-the-curve (AUC) values at 3 and 6 mm in macular segments in all three groups compared with the control group. Conclusion: In macular segment analysis, the inner retinal layers showed the most thinning in patients with ocular hypertensive PXS. According to ROC curve analysis, examinations performed 6 mm inferior to the IPL, as the quadrant with the highest AUC in all three groups, are critical for the early diagnosis of glaucoma.