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Claudia Bartolini, Jason Zhang, Mehreen Adhi, Jay Duker, Chandrasekharan Krishnan; Peripapillary Choroidal Thickness Analysis with Optical Coherence Tomography in Unilateral Pseudoexfoliation Glaucoma and Pseudoexfoliation Syndrome. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4864. doi: https://doi.org/.
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Macular choroidal thickness in eyes affected with pseudoexfoliation in unilateral pseudoexfoliation glaucoma (PXF-G) and unilateral pseudoexfoliation (PXF) is reduced when compared to unaffected fellow eyes. This study aimed to evaluate the peripapillary choroidal thickness in eyes affected with PXF-G and PXF.
A retrospective chart review was performed on 23 patients (46 eyes) with pseudoexfoliation with or without glaucoma from January 2009 to May 2012 at the New England Eye Center, Boston. All patients underwent two high-definition 1-raster scans using Cirrus HD-OCT, one horizontal and one vertical, centered at the optic nerve. Patients were divided into three groups: 1) unilateral PXF-G (n=9), 2) unilateral PXF (n=5) and 3) bilateral PXF (n=9). Two independent graders experienced in analyzing OCT images measured the peripapillary choroidal thickness in both eyes, from the posterior edge of the retinal pigment epithelium to the choroid-scleral junction at 500 um, 1000 um and 1500 um from the optic nerve center in the superior, inferior, nasal and temporal quadrants. The average peripapillary thickness was determined for each eye and the difference in the peripapillary choroidal thickness between the affected and unaffected eye was determined using a paired t-test.
Of the 9 patients with unilateral PXF-G, the average peripapillary choroidal thickness in the eye affected with PXF-G was 112 + 64 um, which was not significantly different from the unaffected fellow eye (115 + 59 um, p=0.91). Of the 9 patients with bilateral PXF, the average peripapillary choroidal thickness between the two affected eyes was not different (112 + 28 um, p=0.65). Similarly, the peripapillary choroidal thickness measurements in the 4 quadrants were not significantly different in the affected and unaffected eyes of patients with unilateral PXF-G and both of the affected eyes of patients with bilateral PXF.
Unlike macular choroidal thickness, the peripapillary choroidal thickness does not appear to be altered in eyes with PXF-G. This suggests that the presence of PXF may be independently associated with thinning of the macular choroid. Further investigation may help determine the cause and effect of PXF with and without glaucoma on the choroid.
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