Individuals with exfoliation syndrome (XFS) may have significantly lower superficial macular vessel densities and less ganglion cells than healthy individuals, a team of researchers from Turkey suggests. Despite these differences, their study, published in the Journal of Glaucoma, also found peripapillary retinal nerve fiber layer (RNFL) thickness and vessel density values were similar between the two groups.

“Our findings implicate microvascular damage [as the] the mechanism underlying XFS-related changes and indicate that it precedes significant structural damage,” the researchers wrote in their paper.

The cross-sectional investigation included 39 eyes of 39 patients with XFS who were diagnosed between 2017 and 2020, and the same number of normal, age-matched healthy individuals in a control group. The researchers used OCT angiography (OCT-A) to image peripapillary and parafoveal superficial vessel densities and to compare RNFL and ganglion cell analysis values between the groups.

The study found no statistically significant differences in central corneal thickness measurements, refractive errors, intraocular pressures, peripapillary vessel density or peripapillary RNFL thickness between XFS and healthy eyes.

However, in the macular region, most superficial vessel density parameters were significantly reduced in the XFS group.

While the average ganglion cell and internal plexiform layer (GCL+IPL) values were similar between groups, the minimum GCL+IPL value was lower in the XFS group.

Although structural test results, especially peripapillary RNFL thickness and mean GCL+IPL, were similar between healthy eyes and the XFS group, macular vessel density values were lower in XFS eyes.

Gür Güngör S, Sarıgül Sezenöz A, Öztürk C, et al. Peripapillary and macular vessel density measurement with optical coherence angiography in exfoliation syndrome. J Glaucoma. September 24, 2020. [Epub ahead of print].