Retinal vascular occlusions occur more frequently in the more affected eye in exfoliation syndrome

To evaluate the relationship between retinal vascular occlusions (RVOs) and exfoliation syndrome (XFS) in a cohort of patients with the two conditions.

We reviewed the records of patients with XFS with or without glaucoma and any type of RVO between 1983 and 2007. Patients with prior incisional surgery or a history of uveitis were excluded. Data collected included demographics, systemic comorbidities, type of RVO, and intraocular pressure (IOP) before the RVO. Slit-lamp biomicroscopy regarding the presence of exfoliation material on the lens capsule and pupillary margin before the vascular event was used to evaluate the laterality and degree of XFS.

We identified 36 patients (mean age 78.4+/-8.3 years, 19 women). Most patients were of European descent (34/36) and 20 (56%) had no prior glaucoma diagnosis. The most common retinal vascular events were central retinal vein occlusion (18/36) and BRVO (10/36). Mean IOP between eyes with (19.5+/-6.5 mm Hg) and without (17.9+/-4.8 mm Hg) RVO was similar (P=0.12). RVOs occurred more commonly in the eye with more pronounced XFS in 92% (33/36) of the cases. A similar agreement was found when considering patients with and without glaucoma separately (94% (15/16) vs90% (18/20); P=0.83). In addition, no difference in the agreement percentage was observed when comparing patients with unilateral XFS (87% (13/15)) with all study patients (P=0.87).

Retinal vascular occlusion in patients with XFS occurs most often in the affected or more severely affected eye. As vascular occlusions happened in patients with and without glaucoma in similar proportions, the presence of XFS seems to play an important role in these findings.