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Published in: International Ophthalmology 3/2020

01-03-2020 | Original Paper

Corneal sublayer thickness in patients with pseudoexfoliation syndrome evaluated by anterior segment optical coherence tomography

Authors: Abdulhakim Tekce, Mehmet Gulmez

Published in: International Ophthalmology | Issue 3/2020

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Abstract

Purpose

The aim of the study was to evaluate the thickness of each corneal sublayer in patients with pseudoexfoliation syndrome (PXS).

Methods

The study’s sample consisted of the 74 eyes of 74 patients with PXS (group 1) and the 80 eyes of 80 individuals without PXS (group 2). Each participant was performed anterior segment optical coherence tomography (AS-OCT) and Pentacam–Scheimpflug imaging. The thicknesses of corneal epithelium, Bowman’s layer, stroma, and Descemet membrane–endothelial complex were measured separately from the AS-OCT images, on the central, 2 mm superior and inferior of the cornea. Central corneal thickness (CCT), apical corneal thickness (ACT), thinnest corneal thickness (TCT), and corneal volume were also evaluated.

Results

According to the measurements of corneal topography, in group 1 versus group 2, mean CCT (529.85 ± 32.33 µm vs 551.36 ± 39.12 µm, p < 0.001), mean ACT (532.21 ± 35.56 µm vs 552.26 ± 49.24 µm, p < 0.001), and mean TCT (527.54 ± 51.45 µm vs 546.20 ± 49.20 µm, p = 0.002) were significantly thinner in group 1. In AS-OCT, the thickness of the epithelium, stroma, and Descemet membrane–endothelial complex in the central, inferior, and superior cornea were significantly thinner in group 1 than in group 2. However, the thickness of Bowman’s layer did not significantly differ between the groups.

Conclusions

Our results indicate that all corneal sublayers except Bowman’s layer were thinner in eyes with PXS than in healthy ones. Therefore, caution should be exercised for corneal involvement in patients with PXS.
Literature
1.
go back to reference Naumann GO, Schlötzer-Schrehardt U, Küchle M (1998) Pseudoexfoliation syndrome for the comprehensive ophthalmologist: intraocular and systemic manifestations. Ophthalmology 105(6):951–968CrossRef Naumann GO, Schlötzer-Schrehardt U, Küchle M (1998) Pseudoexfoliation syndrome for the comprehensive ophthalmologist: intraocular and systemic manifestations. Ophthalmology 105(6):951–968CrossRef
2.
go back to reference Jonasson F, Damji K, Arnarsson A, Sverrisson T, Wang L, Sasaki H, Sasaki K (2003) Prevalence of open-angle glaucoma in Iceland: Reykjavik eye study. Eye 17(6):747CrossRef Jonasson F, Damji K, Arnarsson A, Sverrisson T, Wang L, Sasaki H, Sasaki K (2003) Prevalence of open-angle glaucoma in Iceland: Reykjavik eye study. Eye 17(6):747CrossRef
3.
go back to reference Ringvold A (1999) Epidemiology of the pseudo-exfoliation syndrome. A review. Acta Ophthalmol Scand 77(4):371–375CrossRef Ringvold A (1999) Epidemiology of the pseudo-exfoliation syndrome. A review. Acta Ophthalmol Scand 77(4):371–375CrossRef
4.
go back to reference Ritch R, Schlötzer-Schrehardt U, Konstas AG (2003) Why is glaucoma associated with exfoliation syndrome? Prog Retin Eye Res 22(3):253–275CrossRef Ritch R, Schlötzer-Schrehardt U, Konstas AG (2003) Why is glaucoma associated with exfoliation syndrome? Prog Retin Eye Res 22(3):253–275CrossRef
6.
go back to reference Kocabeyoglu S, Mocan MC, Irkec M, Karakaya J (2016) In vivo confocal microscopic evaluation of corneas in patients with exfoliation syndrome. J Glaucoma 25(2):193–197CrossRef Kocabeyoglu S, Mocan MC, Irkec M, Karakaya J (2016) In vivo confocal microscopic evaluation of corneas in patients with exfoliation syndrome. J Glaucoma 25(2):193–197CrossRef
7.
go back to reference Zheng X, Shiraishi A, Okuma S, Mizoue S, Goto T, Kawasaki S, Uno T, Miyoshi T, Ruggeri A, Ohashi Y (2011) In vivo confocal microscopic evidence of keratopathy in patients with pseudoexfoliation syndrome. Invest Ophthalmol Vis Sci 52(3):1755–1761CrossRef Zheng X, Shiraishi A, Okuma S, Mizoue S, Goto T, Kawasaki S, Uno T, Miyoshi T, Ruggeri A, Ohashi Y (2011) In vivo confocal microscopic evidence of keratopathy in patients with pseudoexfoliation syndrome. Invest Ophthalmol Vis Sci 52(3):1755–1761CrossRef
8.
go back to reference Zheng X, Sakai H, Goto T, Namiguchi K, Mizoue S, Shiraishi A, Sawaguchi S, Ohashi Y (2011) Anterior segment optical coherence tomography analysis of clinically unilateral pseudoexfoliation syndrome: evidence of bilateral involvement and morphologic factors related to asymmetry. Invest Ophthalmol Vis Sci 52(8):5679–5684CrossRef Zheng X, Sakai H, Goto T, Namiguchi K, Mizoue S, Shiraishi A, Sawaguchi S, Ohashi Y (2011) Anterior segment optical coherence tomography analysis of clinically unilateral pseudoexfoliation syndrome: evidence of bilateral involvement and morphologic factors related to asymmetry. Invest Ophthalmol Vis Sci 52(8):5679–5684CrossRef
9.
go back to reference Fernández-Vigo JI, García-Feijóo J, Martínez-de-la-Casa JM, García-Bella J, Arriola-Villalobos P, Fernández-Pérez C, Fernández-Vigo JÁ (2016) Fourier domain optical coherence tomography to assess the iridocorneal angle and correlation study in a large Caucasian population. BMC Ophthalmol 16(1):42CrossRef Fernández-Vigo JI, García-Feijóo J, Martínez-de-la-Casa JM, García-Bella J, Arriola-Villalobos P, Fernández-Pérez C, Fernández-Vigo JÁ (2016) Fourier domain optical coherence tomography to assess the iridocorneal angle and correlation study in a large Caucasian population. BMC Ophthalmol 16(1):42CrossRef
10.
go back to reference Imamoglu S, Sevim MS, Alpogan O, Ercalik NY, Kumral ET, Pekel G, Bardak H (2016) In vivo biometric evaluation of Schlemm’s canal with spectral-domain optical coherence tomography in pseuduexfoliation glaucoma. Acta Ophthalmol (Copenh) 94(8):e688–e692CrossRef Imamoglu S, Sevim MS, Alpogan O, Ercalik NY, Kumral ET, Pekel G, Bardak H (2016) In vivo biometric evaluation of Schlemm’s canal with spectral-domain optical coherence tomography in pseuduexfoliation glaucoma. Acta Ophthalmol (Copenh) 94(8):e688–e692CrossRef
11.
go back to reference Rabsilber TM, Khoramnia R, Auffarth GU (2006) Anterior chamber measurements using Pentacam rotating Scheimpflug camera. J Cataract Refract Surg 32(3):456–459CrossRef Rabsilber TM, Khoramnia R, Auffarth GU (2006) Anterior chamber measurements using Pentacam rotating Scheimpflug camera. J Cataract Refract Surg 32(3):456–459CrossRef
12.
go back to reference Urbaniak D, Seredyka-Burduk M, Błoch W, Malukiewicz G, Kałuzny BJ (2018) Scheimpflug camera measurement of optical density of the corneal epithelium, stroma, and endothelium in patients with pseudoexfoliation syndrome. Med Sci Monit Int Med J Exp Clin Res 24:5826 Urbaniak D, Seredyka-Burduk M, Błoch W, Malukiewicz G, Kałuzny BJ (2018) Scheimpflug camera measurement of optical density of the corneal epithelium, stroma, and endothelium in patients with pseudoexfoliation syndrome. Med Sci Monit Int Med J Exp Clin Res 24:5826
13.
go back to reference Gunes A, Yigit M, Tok L, Tok O (2016) Evaluation of anterior segment parameters in patients with pseudoexfoliation syndrome using Scheimpflug imaging. Arq Bras Oftalmol 79(3):177–179CrossRef Gunes A, Yigit M, Tok L, Tok O (2016) Evaluation of anterior segment parameters in patients with pseudoexfoliation syndrome using Scheimpflug imaging. Arq Bras Oftalmol 79(3):177–179CrossRef
14.
go back to reference Martone G, Casprini F, Traversi C, Lepri F, Pichierri P, Caporossi A (2007) Pseudoexfoliation syndrome: in vivo confocal microscopy analysis. Clin Exp Ophthal 35(6):582–585CrossRef Martone G, Casprini F, Traversi C, Lepri F, Pichierri P, Caporossi A (2007) Pseudoexfoliation syndrome: in vivo confocal microscopy analysis. Clin Exp Ophthal 35(6):582–585CrossRef
15.
go back to reference Naumann GO, Schlötzer-Schrehardt U (2000) Keratopathy in pseudoexfoliation syndrome as a cause of corneal endothelial decompensation. Ophthalmology 107(6):1111–1124CrossRef Naumann GO, Schlötzer-Schrehardt U (2000) Keratopathy in pseudoexfoliation syndrome as a cause of corneal endothelial decompensation. Ophthalmology 107(6):1111–1124CrossRef
16.
go back to reference Yüksel N, Emre E, Pirhan D (2016) Evaluation of corneal microstructure in pseudoexfoliation syndrome and glaucoma: in vivo scanning laser confocal microscopic study. Curr Eye Res 41(1):34–40CrossRef Yüksel N, Emre E, Pirhan D (2016) Evaluation of corneal microstructure in pseudoexfoliation syndrome and glaucoma: in vivo scanning laser confocal microscopic study. Curr Eye Res 41(1):34–40CrossRef
17.
go back to reference Zimmermann N, Wünscher M, Schlötzer-Schrehardt U, Erb C (2014) Corneal endothelial cell density and its correlation with the severity of pseudoexfoliation. Klin Monbl Augenheilkd 231(2):158–163CrossRef Zimmermann N, Wünscher M, Schlötzer-Schrehardt U, Erb C (2014) Corneal endothelial cell density and its correlation with the severity of pseudoexfoliation. Klin Monbl Augenheilkd 231(2):158–163CrossRef
18.
go back to reference Schlötzer-Schrehardt U, Jr Lommatzsch, Küchle M, Konstas AG, Naumann GO (2003) Matrix metalloproteinases and their inhibitors in aqueous humor of patients with pseudoexfoliation syndrome/glaucoma and primary open-angle glaucoma. Invest Ophthalmol Vis Sci 44(3):1117–1125CrossRef Schlötzer-Schrehardt U, Jr Lommatzsch, Küchle M, Konstas AG, Naumann GO (2003) Matrix metalloproteinases and their inhibitors in aqueous humor of patients with pseudoexfoliation syndrome/glaucoma and primary open-angle glaucoma. Invest Ophthalmol Vis Sci 44(3):1117–1125CrossRef
19.
go back to reference Patel SV, McLaren JW, Hodge DO, Bourne WM (2001) Normal human keratocyte density and corneal thickness measurement by using confocal microscopy in vivo. Invest Ophthalmol Vis Sci 42(2):333–339PubMed Patel SV, McLaren JW, Hodge DO, Bourne WM (2001) Normal human keratocyte density and corneal thickness measurement by using confocal microscopy in vivo. Invest Ophthalmol Vis Sci 42(2):333–339PubMed
20.
go back to reference Sein J, Galor A, Sheth A, Kruh J, Pasquale LR, Karp CL (2013) Exfoliation syndrome: new genetic and pathophysiologic insights. Curr Opin Ophthalmol 24(2):167–174CrossRef Sein J, Galor A, Sheth A, Kruh J, Pasquale LR, Karp CL (2013) Exfoliation syndrome: new genetic and pathophysiologic insights. Curr Opin Ophthalmol 24(2):167–174CrossRef
21.
go back to reference Demirdögen B, Ceylan OM, Isikoglu S, Mumcuoglu T, Erel O (2014) Evaluation of oxidative stress and paraoxonase phenotypes in pseudoexfoliation syndrome and pseudoexfoliation glaucoma. Clin Lab 60(1):79–86PubMed Demirdögen B, Ceylan OM, Isikoglu S, Mumcuoglu T, Erel O (2014) Evaluation of oxidative stress and paraoxonase phenotypes in pseudoexfoliation syndrome and pseudoexfoliation glaucoma. Clin Lab 60(1):79–86PubMed
22.
go back to reference Gagnon M-M, Boisjoly HM, Brunette I, Charest M, Amyot M (1997) Corneal endothelial cell density in glaucoma. Cornea 16(3):314–318CrossRef Gagnon M-M, Boisjoly HM, Brunette I, Charest M, Amyot M (1997) Corneal endothelial cell density in glaucoma. Cornea 16(3):314–318CrossRef
23.
go back to reference Oliveira-Soto L, Efron N (2001) Morphology of corneal nerves using confocal microscopy. Cornea 20(4):374–384CrossRef Oliveira-Soto L, Efron N (2001) Morphology of corneal nerves using confocal microscopy. Cornea 20(4):374–384CrossRef
24.
go back to reference Eghrari AO, Riazuddin SA, Gottsch JD (2015) Overview of the cornea: structure, function, and development. Prog Mol Biol Transl Sci 134:7–23CrossRef Eghrari AO, Riazuddin SA, Gottsch JD (2015) Overview of the cornea: structure, function, and development. Prog Mol Biol Transl Sci 134:7–23CrossRef
25.
go back to reference Oltulu R, Satirtav G, Kayitmazbatir ET, Bitirgen G, Ozkagnici A, Karaibrahimoglu A (2015) Characteristics of the cornea in patients with pseudoexfoliation syndrome. Arq Bras Oftalmol 78(6):348–351CrossRef Oltulu R, Satirtav G, Kayitmazbatir ET, Bitirgen G, Ozkagnici A, Karaibrahimoglu A (2015) Characteristics of the cornea in patients with pseudoexfoliation syndrome. Arq Bras Oftalmol 78(6):348–351CrossRef
26.
go back to reference Doganay S, Tasar A, Cankaya C, Firat PG, Yologlu S (2012) Evaluation of Pentacam-Scheimpflug imaging of anterior segment parameters in patients with pseudoexfoliation syndrome and pseudoexfoliative glaucoma. Clin Exp Optom 95(2):218–222CrossRef Doganay S, Tasar A, Cankaya C, Firat PG, Yologlu S (2012) Evaluation of Pentacam-Scheimpflug imaging of anterior segment parameters in patients with pseudoexfoliation syndrome and pseudoexfoliative glaucoma. Clin Exp Optom 95(2):218–222CrossRef
Metadata
Title
Corneal sublayer thickness in patients with pseudoexfoliation syndrome evaluated by anterior segment optical coherence tomography
Authors
Abdulhakim Tekce
Mehmet Gulmez
Publication date
01-03-2020
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 3/2020
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-019-01214-5

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