ISSN : 2146-3123
E-ISSN : 2146-3131

Retinal and Choroidal Vascular Changes in Eyes with Pseudoexfoliation Syndrome: a Comparative Study Using Optical Coherence Tomography Angiography
Esat Çınar1, Berna Yüce2, Fatih Aslan3
1Clinic of Ophthalmology, Ekol Hospital, İzmir, Turkey
2Clinic of Ophthalmology, İzmir University of Health Sciences, Tepecik Training and Research Hospital, İzmir, Turkey
3Clinic of Ophthalmology, Alanya Alaattin Keykubat University Training and Research Hospital, Antalya, Turkey
DOI : 10.4274/balkanmedj.galenos.2019.2019.5.5

Background: Optical coherence tomography angiography (OCTA) allows the detailed evaluation of retinal and choroidal microvascular structures with no need for a contrast agent. Pseudoexfoliation (PEX) is a condition that leads to anatomical and functional losses due to the accumulation of degraded abnormal fibrillar material in the intraocular and extraocular tissues. Histopathological studies have shown that the accumulation of PEX material in vascular structures may play a role in different pathologies such as retinal vein occlusion, iris hypoperfusion, anterior segment hypoxia, retinal arterial occlusion, and neovascular glaucoma.
Aims: To evaluate and compare flow and vascular density in the retina and choroid in eyes with pseudoexfoliation (PEX), non-PEX fellow eyes, and healthy eyes using optical coherence tomography angiography (OCTA).
Study Design: Cross-sectional case control study.
Methods: The study included 35 PEX eyes of 35 PEX patients, 32 non-PEX fellow eyes of 32 unilateral PEX patients, and 35 eyes of healthy control subjects. Flow area and vessel density (VD) in the superficial capillary plexus (SCP) and deep vascular plexus (DCP) were measured by OCTA as three separate parameters: total, parafoveal, and foveal. Choroidal thickness (CT) and foveal avascular zone (FAZ) area were measured for each patient.
Results: There were significant differences between the PEX eyes and control eyes in total, parafoveal, and foveal flow and VD in the SCP (P<0.05 for all), while there were no significant differences between these groups in any of the flow or VD values in the DCP (P>0.05). None of the SCP and DCP flow and VD values showed significant differences between PEX eyes and non-PEX fellow eyes or between fellow eyes and control eyes (P>0.05). CT was significantly lower in PEX eyes compared to control eyes. FAZ area was significantly enlarged in PEX eyes compared to control eyes in both the superficial and deep layers (P<0.05).
Conclusion: PEX eyes have significant damage to the retinal and choroidal vascular structures associated with PEX material.

Keywords : Optical coherence tomography angiography, pseudoexfoliation, retinal vascular structure
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