Association with Systemic and Ophthalmic Disease in Korean Pseudoexfoliation Syndrome Patients

Purpose@#To analyze the association of systemic and ophthalmic disease in patients with pseudoexfoliation syndrome. @*Methods@#We retrospectively reviewed the records of 207 patients with pseudoexfoliation syndrome and 201 age-matched controls without pseudoexfoliation syndrome seen from January 2016 to January 2021. Age, sex, systemic diseases such as diabetes mellitus, hypertension, cardiovascular and cerebrovascular disease, and ocular disease including retinal vascular occlusion, age-related macular degeneration (AMD), glaucoma, cataract surgery rate, complications related to cataract surgery, and ocular characteristics were compared. Factors associated with pseudoexfoliation syndrome were analyzed using logistic regression. @*Results@#The frequencies of diabetes mellitus, hypertension, AMD, glaucoma, a history of cataract surgery, and complications related to cataract surgery were significantly higher in patients with pseudoexfoliation syndrome (all Ps ≤ 0.049). The pseudoexfoliation syndrome group had a significantly thinner global retinal nerve fiber layer, worse mean deviation and pattern standard deviation, and smaller dilated pupil size than the controls (all Ps < 0.001). In univariate and multivariate logistic regressions, the presence of diabetes mellitus (odds ratio [OR] = 1.613, p = 0.041), AMD (OR = 3.071, p = 0.001), and glaucoma (OR = 17.800, p < 0.001) were associated with pseudoexfoliation syndrome. @*Conclusions@#Diabetes mellitus, hypertension, AMD, and glaucoma were more frequent in pseudoexfoliation syndrome patients. Since pseudoexfoliation syndrome is closely related to AMD and glaucoma, this requires clinical consideration.

Retinal Nerve Fiber Layer Thickness Measurement Comparison Using Spectral Domain and Swept Source Optical Coherence Tomography

PURPOSE: To investigate the retinal nerve fiber layer (RNFL) thickness concordance when measured by spectral domain (SD) and swept source (SS) optical coherence tomography (OCT), and to compare glaucoma-discriminating capability. METHODS: RNFL thicknesses were measured with the scan circle, centered on the optic nerve head, in 55 healthy, 41 glaucoma suspected, and 87 glaucomatous eyes. The RNFL thickness measured by the SD-OCT (sdRNFL thickness) and SS-OCT (ssRNFL thickness) were compared using the t-test. Bland-Altman analysis was performed to examine their agreement. We compared areas under the receiver operating characteristics curve and examined sdRNFL and ssRNFL thickness for discriminating glaucomatous eyes from healthy eyes, and from glaucoma suspect eyes. RESULTS: The average ssRNFL thickness was significantly greater than sdRNFL thickness in healthy (110.0 ± 7.9 vs. 100.1 ± 6.8 µm, p < 0.001), glaucoma suspect (96.8 ± 9.3 vs. 89.6 ± 7.9 µm, p < 0.001), and glaucomatous eyes (74.3 ± 14.2 vs. 69.1 ± 12.4 µm, p = 0.011). Bland-Altman analysis showed that there was a tendency for the difference between ssRNFL and sdRNFL to increase in eyes with thicker RNFL. The area under the curves of the average sdRNFL and ssRNFL thickness for discriminating glaucomatous eyes from healthy eyes (0.984 vs. 0.986, p = 0.491) and glaucoma suspect eyes (0.936 vs. 0.918, p = 0.132) were comparable. CONCLUSIONS: There was a tendency for ssRNFL thickness to increase, compared with sdRNFL thickness, in eyes with thicker RNFL. The ssRNFL thickness had comparable diagnostic capability compared with sdRNFL thickness for discriminating glaucomatous eyes from healthy eyes and glaucoma suspect eyes.

Subfoveal Choroidal Thickness in Fellow Eyes of Patients with Central Serous Chorioretinopathy

PURPOSE: To determine the relationship between subfoveal choroidal thickness of fellow eyes and choroidal vascular hyperpermeability in unilateral central serous chorioretinopathy (CSC). METHODS: Thirty patients with unilateral CSC and 28 normal subjects underwent enhanced depth imaging spectral-domain optical coherence tomography to evaluate bilateral subfoveal choroidal thickness. The subfoveal choroidal thickness was measured from the outer RPE border to the inner sclera border. Choroidal vascular hyperpermeability was visualized with indocyanine green angiography (ICGA) and analyzed. RESULTS: The mean subfoveal choroidal thickness in the affected eyes (439.6 +/- 136.5 microm) was significantly thicker than that in fellow eyes (340.0 +/- 103.3 microm, p = 0.002), and both showed statistically significant difference compared with normal subjects (266.5 +/- 111.5 microm, p < 0.001, p = 0.019). The subfoveal choroidal thickness of fellow eyes with choroidal vascular hyperpermeability was 370.0 +/- 176.5 microm, which differed significantly (p = 0.037) from the choroid without choroidal vascular hyperpermeability. The choroidal thickness of acute CSC was 441.6 +/- 118.6 microm, and that of chronic CSC was 454 +/- 166.5 microm, a difference that was not statistically significant (p = 0.676). CONCLUSIONS: The subfoveal choroid with hyperpermeability was thicker than that without hyperpermeability on ICGA in the fellow eyes of patients with unilateral CSC. Enhanced depth imaging spectral-domain optical coherence tomography can indirectly evaluate the effects of choroidal hyperpermeability by noninvasively measuring the choroidal thickness.

Laser-Induced Choroidal Neovascularization in Central Serous Chorioretinopathy: 4 Cases

PURPOSE: To report the choroidal neovascularization of 4 patients in central serous chorioretinopathy treated with laser treatment. CASE SUMMARY: We reported 4 patients with central serous chorioretinopathy. Three patients were treated with focal laser photocoagulation, and 1 patient with photodynamic treatment. All patients newly developed choroidal neovascularization (CNV) after treatment at the area of laser treatment. Three patients received intravitreal anti-VEGF injection and 1 patient received argon laser photocoagulation for the treatment of CNV. After the treatment, the CNV was resolved with improved visual acuity. CONCLUSIONS: Laser treatment may be efficacious tool to achieve rapid resolution in central serous chorioretinopathy until now. However, more caution at the time of treatment and close follow-up after treatment are warranted.