Päivi Puska1, Mika Harju. 1. Helsinki University Eye Hospital, Haartmaninkatu 4C, P.O. Box 220, FIN-00029 HYKS, Helsinki, Finland. paivi.puska@hus.fi
Abstract
BACKGROUND: Optic nerve head damage may result from high intraocular pressure (IOP) associated with the exfoliation syndrome (EXS). At equal IOP levels, eyes with EXS may suffer damage more easily than eyes without EXS. Opinion differs as to whether EXS alone, without the contributory effect of a raised IOP, is a risk factor for optic nerve head damage. METHODS: 36 nonglaucomatous, normotensive patients (mean age 68.4 +/- 7.1 years) with unilateral EXS were examined for optic disc topography with confocal scanning laser ophthalmoscopy (the Heidelberg Retina Tomograph). The only patients included were those with an IOP difference of < or =3 mmHg between fellow eyes and with IOP fluctuation < or =5 mmHg in diurnal curves. RESULTS: Mean IOP was higher in the EXS than in the fellow non-EXS eyes (15.0 +/- 2.8 vs 14.1 +/- 2.7 mmHg, P < 0.001). According to the multivariate analysis of variance, no differences existed in the global parameters between EXS and non-EXS eyes (P = 0.778). Nor did differences appear in sectoral parameters between fellow eyes in the temporal (P = 0.634), temporal superior (P = 0.236), temporal inferior (P = 0.330), nasal (P = 0.711), nasal superior (P = 0.307), and nasal inferior (P = 0.434) sectors. CONCLUSION: EXS may not in itself be a risk factor for optic disc damage when IOP is not elevated from its base level, and when its variation is normal.
BACKGROUND:Optic nerve head damage may result from high intraocular pressure (IOP) associated with the exfoliation syndrome (EXS). At equal IOP levels, eyes with EXS may suffer damage more easily than eyes without EXS. Opinion differs as to whether EXS alone, without the contributory effect of a raised IOP, is a risk factor for optic nerve head damage. METHODS: 36 nonglaucomatous, normotensive patients (mean age 68.4 +/- 7.1 years) with unilateral EXS were examined for optic disc topography with confocal scanning laser ophthalmoscopy (the Heidelberg Retina Tomograph). The only patients included were those with an IOP difference of < or =3 mmHg between fellow eyes and with IOP fluctuation < or =5 mmHg in diurnal curves. RESULTS: Mean IOP was higher in the EXS than in the fellow non-EXS eyes (15.0 +/- 2.8 vs 14.1 +/- 2.7 mmHg, P < 0.001). According to the multivariate analysis of variance, no differences existed in the global parameters between EXS and non-EXS eyes (P = 0.778). Nor did differences appear in sectoral parameters between fellow eyes in the temporal (P = 0.634), temporal superior (P = 0.236), temporal inferior (P = 0.330), nasal (P = 0.711), nasal superior (P = 0.307), and nasal inferior (P = 0.434) sectors. CONCLUSION: EXS may not in itself be a risk factor for optic disc damage when IOP is not elevated from its base level, and when its variation is normal.