Evaluation of Lamina Cribrosa in Pseudoexfoliation Syndrome Using Spectral-Domain Optical Coherence Tomography Enhanced Depth Imaging

Purpose: To evaluate the features of the lamina cribrosa (LC) in pseudoexfoliation glaucoma (PXG) patients using enhanced depth imaging (EDI) of spectral-domain optical coherence tomography (SD OCT). The results were compared with those of patients with primary open-angle glaucoma (POAG). Design: Cross-sectional study. Participants: Patients with PXG (n = 21) and POAG (n = 35) matched for age and visual field mean deviation (VF MD). Methods: Participants were imaged using SD OCT. Lamina cribrosa thickness (LT) and anterior lamina cribrosa depth (ALD) were determined at 3 areas (mid superior, center, and mid inferior) by 2 examiners using an EDI mode of the optic nerve head. Main Outcome Measures: The LT and ALD were compared between PXG and POAG eyes. Results: Mean +/- standard deviation baseline untreated intraocular pressure was not significantly different between the 2 groups (PXG, 18.3 +/- 8.2 mmHg; POAG, 15.3 +/- 3.4 mmHg; P = 0.310). The mean VF MD was -12.7 +/- 9.0 dB in the PXG group versus -11.6 +/- 9.1 dB in the POAG group (P = 0.643). When compared with the POAG group, the PXG group demonstrated a significantly thinner LT in all 3 areas and a thinner mean LT (133.4 +/- 14.5 mu m in the POAG group vs. 121.3 +/- 13.0 mu m in the PXG group; P<0.001). Anterior lamina cribrosa depth did not demonstrate a significant difference in any of the 3 areas between both groups (mean ALD, 324.3 +/- 91.9 mu m in the POAG group vs. 358.7 +/- 142.7 mu m in the PXG group; P = 0.470). Of 21 eyes in the PXG group, 9 eyes demonstrated a unilateral clinical presentation. When we compared the PXG eyes and the apparently normal-looking fellow eyes of those 9 eyes, neither the LT nor ALD demonstrated a significant difference (P = 0.223 and P = 0.079, respectively). Conclusions: Eyes with PXG demonstrate a thinner LC compared with POAG eyes at similar levels of glaucoma severity.