Corneal Clarity and Tomographic Patterns in Pseudoexfoliation Syndrome: A Severity-Based Investigation

The aim of the study was to investigate the corneal and anterior segment characteristics in pseudoexfoliation syndrome (PXS), depending on the severity of the disease.

This cross-sectional study was conducted at a tertiary care hospital, in the ophthalmology department, in Turkey. Pseudoexfoliation syndrome group was classified into three groups. Pseudoexfoliative material on the part of the pupillary border was classified as group 1, on the entire pupillary border was classified as group 2, and pseudoexfoliative material on the entire pupillary border and iris surface was classified as group 3. The control group was composed of age and gender-matched individuals who had undergone a completely normal ophthalmologic examination. Scheimpflug tomography was performed to record tomographical data.

The PXS groups 1, 2, and 3, along with the control group, consist of 29, 32, 33, and 42 participants, respectively. There was no significant difference in age-gender distribution between patients and the control group ( P >0.05). Group 3 showed significant differences in central corneal thickness compared with the control group ( P =0.001). In addition, anterior chamber angle was found to be significantly lower in group 3 than the control group ( P <0.001). In corneal densitometry (CD) values, significant increases compared with the control group were observed in groups 2 and 3 across all anterior annuli ( P <0.001). In group 1, significant increases observed in the anterior 6-10 mm and 10-12 mm annuli ( P <0.001). In the middle 6-10 mm annuluses, only group 3 showed a significant increase compared with the control group ( P <0.001). In the posterior 0-2, 2-6, and 6-10 mm annuli, significant increases compared with the control were observed only in groups 2 and 3 ( P =0.001, P =0.001, P <0.001, respectively).

Corneal densitometry values, even without an increase in intraocular pressure, have a tendency to increase in PXS depending on the severity of the disease. While minimal changes were observed in the middle layer, it was particularly noted that the effects of the disease were more prominent in the peripheral cornea.