K 345
Optic disc size in glaucoma patients with asymmetric pseudo-exfoliation syndrome
W. M. Budde
Purpose: Cross-sectional studies have suggested that pseudoexfoliative glaucoma is associated with a small optic disc. Since selection artifacts could not be ruled out, the present study re-addressed the question by examining inter-eye differences in optic disc size in glaucoma patients with clinically unilateral pseudoexfoliation.
Patients and Methods: The study included 22 patients with bilateral open-angle glaucoma and clinically unilaterally pseudoexfoliation syndrome and 47 unselected normal subjects. The contralateral open-angle glaucoma eye without clinically detectable pseudoexfoliation syndrome and one randomly selected eye of each of the 47 normal subjects served as control. The area of the optic disc was assessd by morphometric evaluation of color stereo optic disc photographs.
Results: In an intraindividual inter-eye comparison within the glaucoma group, the optic disc size was not significantly different between the eye with pseudoexfoliative glaucoma and the contralateral glaucomatous eye without clinical signs of pseudoexfoliation (2.45 ± 0.51 mm² versus 2.55 ± 0.60 mm², P=0.17, Student t test for paired samples, 95% CI for the difference: -0.24 to +0.05 mm²). Correspondingly, the pseudoexfoliative glaucomatous eyes and the normal eyes did not differ significantly in optic disc size (normal eyes: 2.55 ± 0.48 mm², P=0.42, Student t test for unrelated samples, 95% CI for the difference: -0.37 to +0.16 mm²).
Conclusion: The presence of pseudoexfoliation syndrome in patients with clinically unilateral pseudoexfoliative glaucoma may be independent of optic disc size. In contrast to previous studies, pseudoexfoliative glaucoma may not be associated with an abnormally small optic disc.
Department of Ophthalmology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, D-91054 Erlangen, Germany