DIAGNOSTIC AGREEMENT BETWEEN OPTICAL COHERENCE TOMOGRAPHY AND HEIDELBERG RETINAL TOMOGRAPHY IN PSEUDOEXFOLIATION
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Keywords
Pseudoexfoliation syndrome; Optical coherence tomography; Heidelberg retina tomography; Retinal nerve fiber layer; Optic nerve head; Glaucoma; Intraocular pressure
Abstract
Objective: This investigation sought to compare the diagnostic performance of optical coherence tomography (OCT) and Heidelberg retina tomography (HRT) in evaluating optic nerve head (ONH) morphology in individuals presenting with pseudoexfoliation syndrome, both with and without intraocular pressure (IOP) elevation. Methods: We conducted a prospective observational study involving 192 participants (age range: 65-78 years) divided into three groups: healthy controls (n=56), pseudoexfoliation without IOP elevation (n=68, Group 2), and pseudoexfoliation with elevated IOP (n=68, Group 1). All participants underwent comprehensive ophthalmologic assessment including Goldmann applanation tonometry, automated perimetry (Humphrey 30-2), Stratus OCT III for retinal nerve fiber layer (RNFL) thickness measurement, and HRT III for ONH parameter evaluation. Statistical analyses included one-way ANOVA and Kruskal-Wallis testing with appropriate post-hoc comparisons. Results: Significant alterations in RNFL thickness across all quadrants (average, superior, inferior, temporal, and nasal) were documented in Group 1 compared to controls and Group 2. Cup-to-disc (C/D) ratios demonstrated progressive increase from controls through Group 2 to Group 1, while rim area measurements showed corresponding decreases. Both OCT and HRT parameters exhibited strong correlations with visual field indices, particularly mean deviation (MD) and pattern standard deviation (PSD). Superior quadrant RNFL measurements showed the strongest correlation between imaging modalities. Conclusions: Both OCT and HRT demonstrated capability in detecting early structural changes in pseudoexfoliation syndrome, even preceding visual field deficits. These imaging technologies offer complementary information for monitoring glaucomatous progression in pseudoexfoliation patients. The findings support routine implementation of both modalities in clinical assessment protocols for patients with pseudoexfoliation syndrome, regardless of IOP status
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Dr. Chamundeswari Nalla
Assistant Professor, Department of Ophthalmology, Sri Lakshmi Narayana Institute of Medical Science, Pondicherry, India.
