Assessment Of Anterior Segment Parameters In Pseudoexfoliation Syndrome Using Ultrasound Biomicroscopy

To compare anterior segment and angle parameters between pseudoexfoliation syndrome(PEX) and pseudoexfoliation glaucoma (PEXG) and normal control subjects  based on ultrasound biomicroscopy (UBM).

Department of Ophthalmology of the Military Hospital, Tunis, Tunisia.

A prospective, cross-sectional comparative study was carried out from January 2022 to September 2022. Subjects with PEXG, PEX and normal eyes as the control group were enrolled for the study. We noted the patients' best-corrected visual acuity (BCVA), the intraocular pressure (IOP), gonioscopy, and fundus examination. Anterior segment imaging was performed on each eye using UBM (Aviso Lin- 50; Quantel Medical). The following biometric parameters of the anterior segment were measured: lens vault (LV), iris Thickness (IT), angle opening distance (AOD 500), angle recess area (ARA 750), and trabecular iris space area (TISA 750). We compared all parameters between the different groups.

Data from 11 eyes with pseudoexfoliation glaucoma (PEXG), 11 eyes with pseudoexfoliation syndrome (PEX) and 11 eyes of normal control subjects were analyzed. The mean age was 38,7 ± 5.3 years (15 female). The BCVA was significantly lower in eyes with PEXG than in PEX and normal eyes (0.73 ± 0.21; 1.0 respectively; p<0.05). All iridocorneal angle parameters (AOD 500, ARA 750, TISA750) were significantly lower in in PEXG compared to PXS and controls (all p<0,05). Lens vault (LV) was larger in PEXG (0.47 ± 0.20) and PEX (0.45 ± 0.22) compared to controls (0.31 ± 0.1).

PXG eyes have the narrowest anterior chamber angle parameters. There is a progressive decrease in angle parameters from controls to PXS to PXG. Narrow anterior chamber angle and ACD may have a role in the progression of pseudoexfoliation syndrome to glaucoma. Detection of narrow angle in these patients may help clinician to proper management of the disease