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Optic nerve head microvascular characteristics in patients with unilateral pseudoexfoliation syndrome: an optical coherence tomography angiography study

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Abstract

Purpose

To compare vascular microcirculation changes of the optic nerve head (ONH) and to evaluate the peripapillary retinal nerve fiber layer (RNFL) in the patients with unilateral pseudoexfoliation syndrome (PEXS), other eyes of these patients without PEXS and healthy control eyes using optical coherence tomography angiography (OCTA) and spectral domain optical coherence tomography (SD-OCT).

Methods

 This cross-sectional study enrolled 29 pseudoexfoliative (PEX) and 29 fellow eyes of patients with unilateral PEXS, and 28 healthy eyes as controls. According to inclusion criteria the study group with asymmetric PEXS were normotensive and no glaucoma diagnosis. The vascularity of optic disc was evaluated with OCTA and peripapillary retinal nerve fiber layer with SD-OCT. ONH 4.5 × 4.5 mm OCTA gave us perfusion density (PD) and flow index (FI). Differences between the groups according to continuous variables were determined by independent samples t test. A p value less than 0.05 was considered as significant.

Results

Twenty-nine patients with the mean age of 66.21 ± 7.55 (49–79) years was compared with 28 individuals in control group with mean age of 66.79 ± 4.43 (60–75) years. There was no difference regarding the age (p = 0.725). Female and male distribution in two groups were same (p = 0.219). Intraocular pressure (IOP) in PEXS group was measured as 16.17 ± 4.58 (10–21) mmHg, however IOP in the fellow eye was measured as 14.79 ± 3.35 (11–19) mmHg (p = 0.064) and control group was measured as 12.53 ± 1.66 (10–17) mmHg (p = 0.000). In the group with PEXS, the superior FI was found to be lower 0.39 ± 0.06 (0.26–0.45) (p = 0.008) than control group 0.42 ± 0.21 (0.36–0.45), and temporal FI in PEXS eyes was measured 0.42 ± 0.06 (0.32–0.52), which was significantly lower than control group (p = 0.022). Nasal FI was the parameter which was found significantly different from the PEXS free fellow eyes. The nasal FI value of eyes with PEX was 0.40 ± 0.05 (0.30–0.46), while the same value in PEX free fellow eyes was 0.42 ± 0.04 (0.33–0.47) (p = 0.029).

Conclusions

ONH evaluation with OCTA especially in the nasal segment is important for early diagnosis. OCTA can be a new method in follow-up and early diagnosis of patients with asymmetric PEXS to control ONH microcirculation and to evaluate early glaucomatose changes in both eyes.

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Availability of data and material

The datasets generated during and/or analyzed during the current study are not publicly available due to the involvement of human participants, but are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Funding

None relevant to this study. No financial support was received for this submission.

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Authors and Affiliations

  1. Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey

    Ozlem Dikmetas, Sepideh Lotfi Sadigh, Cansev Şekerler, Sibel Kocabeyoğlu & Ali Bulent Cankaya

  2. Department of Biostatistics, Hacettepe University School of Medicine, Ankara, Turkey

    Sevilay Karahan

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  1. Ozlem Dikmetas
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  2. Sepideh Lotfi Sadigh
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  3. Cansev Şekerler
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  4. Sibel Kocabeyoğlu
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by OD, SLS, CŞ, SK, SK, ABC. The first draft of the manuscript was written by Ozlem Dikmetas and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Ozlem Dikmetas.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Hacettepe University School of Medicine Institutional Review Board (GO 20/564) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Human or animal participants

This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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The study was conducted in the Department of Ophthalmology, Hacettepe University School of Medicine.

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Cite this article

Dikmetas, O., Sadigh, S.L., Şekerler, C. et al. Optic nerve head microvascular characteristics in patients with unilateral pseudoexfoliation syndrome: an optical coherence tomography angiography study. Int Ophthalmol 42, 2397–2405 (2022). https://doi.org/10.1007/s10792-022-02239-z

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