Abstract:

Aim: The aim of this study was to observe interocular variations in macular vascular density among individuals with unilateral pseudoexfoliation material (XFM) and its association with glaucoma development. Material and Methods: The study included a total of 76 eyes from 38 individuals with unilateral pseudoexfoliation syndrome (XFS) and 72 eyes from 36 individuals with unilateral pseudoexfoliation glaucoma (XFG). OCT-A was used to examine all macular markers in both XFM-positive and XFM-negative eyes within each group, and the data were analyzed using the standard mean comparison t-test. Furthermore, the Kruskal-Wallis test was used to compare the XFM-positive and XFM-negative eye groups between the XFS and XFG cohorts. Results: The unilateral XFS group showed relatively infrequent significant differences in superficial capillary plexus density between the eyes. In contrast, the unilateral XFG group exhibited a significant decrease in vascular density in various macular regions, including the total macula (p=0,0004), superior and inferior hemifields (p=0,0018, p=0,0002), fovea (p=0,014), parafovea (p=0,0411), inferior half of parafovea (p=0,0126), and temporal region (p=0,0126). However, the deep capillary plexus showed decreased significance in both within-group and between-group comparisons compared to the superficial vascular layer. Conclusion: Our findings indicate a decrease in macular capillary plexus density, particularly in the superficial region, in glaucoma cases effectively managed with medical treatment. However, this vascular decrease could not be identified as an early sign in the presence of XFM (pseudoexfoliation material), which is a significant risk factor for glaucoma.

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