Optical Coherence Tomography Alteration of the Choroid and Lamina Cribrosa in Pseudoexfoliation Syndrome and Glaucoma.

Abstract

Prcis: This meta-analysis demonstrates significant thinning of the choroid and lamina cribrosa in eyes with pseudoexfoliation syndrome and pseudoexfoliative glaucoma compared with healthy controls, emphasizing OCT's potential utility for early glaucoma detection in these patients.

Background: Pseudoexfoliation syndrome (PXS) is a significant risk factor for pseudoexfoliative glaucoma (PXG), impacting posterior segment tissues such as the choroid and lamina cribrosa (LC). This research aims to investigate the effects of PXS on these layers compared with healthy controls using optical coherence tomography (OCT).

Methods: Following the PRISMA checklist, this systematic review, registered at PROSPERO (CRD42023415302), examined OCT measurements in PXS and PXG patients. Searches were conducted in PubMed, Scopus, and EMBASE until April 2023. Selection criteria included human observational studies assessing choroid and lamina cribrosa layers with OCT in PXS and PXG patients. Statistical analyses, including meta-analysis, bias detection, subgroup analysis, and metaregression, were performed.

Results: A total of 22 studies, comprising 2293 participants (717 PXG patients, 708 PXS patients, and 868 healthy controls), underwent meta-analysis. In PXG cases, subfoveal choroidal thickness (CT), as well as CT at 1500 µm and 3000 µm temporal and nasal to the fovea, were significantly decreased compared with healthy individuals. In addition, average peripapillary CT and average LCT were significantly reduced in PXG eyes compared with healthy controls. Similarly, eyes with PXS exhibited significantly lower values for subfoveal CT, CT at 1500 µm temporal and 3000 µm nasal to the fovea, average peripapillary CT, and average LC thickness compared with healthy controls.

Conclusion: This meta-analysis confirms previously reported decreases in CT and LC thickness in patients with PXG and PXS. Continuous monitoring of choroid and LC using OCT may facilitate the early detection of glaucoma in patients with PXS, addressing a key concern in their management.