© 2013 Wichtig Editore - ISSN 1120-6721
Eur J Ophthalmol ( 2013; : 5) 743-750 23
743
Scanning laser polarimetry in eyes with exfoliation
syndrome
Antonios T. Dimopoulos
1
, Andreas Katsanos
2
, Dimitrios G. Mikropoulos
1
, Theodoros Giannopoulos
1
,
Theodoros Empeslidis
1
, Miguel A. Teus
3
, Gábor Holló
4
, Anastasios G.P. Konstas
1
1
1st University Department of Ophthalmology, Thessaloniki - Greece
2
Department of Ophthalmology, University of Ioannina, Ioannina - Greece
3
Universidad de Alcalá, Alcalá de Henares, Madrid - Spain
4
Department of Ophthalmology, Semmelweis University, Budapest - Hungary
Purpose: To compare retinal nerve fiber layer thickness (RNFLT) of normotensive eyes with exfoliation
syndrome (XFS) and healthy eyes.
Methods: Sixty-four consecutive individuals with XFS and normal office-time intraocular pressure
(IOP) and 72 consecutive healthy controls were prospectively enrolled for a cross-sectional analy-
sis in this hospital-based observational study. The GDx-VCC parameters (temporal-superior-nasal-
inferior-temporal [TSNIT] average, superior average, inferior average, TSNIT standard deviation (SD),
and nerve fiber indicator [NFI]) were compared between groups. Correlation between various clinical
parameters and RNFLT parameters was investigated with Spearman coefficient.
Results: The NFI, although within normal limits for both groups, was significantly greater in the XFS
group compared to controls: the respective median and interquartile range (IQR) values were 25.1
(22.0-29.0) vs 15.0 (12.0-20.0), p<0.001. In the XFS group, all RNFLT values were significantly lower
compared to controls (p<0.001). However, they were all within the normal clinical ranges for both
groups: TSNIT average median (IQR): 52.8 (49.7-55.7) vs 56.0 (53.0-59.3) μm; superior average mean
(SD): 62.3 (6.7) vs 68.8 (8.2) μm; inferior average mean (SD): 58.0 (7.2) vs 64.8 (7.7) μm, respectively.
TSNIT SD was significantly lower in the XFS group, median (IQR): 18.1 (15.4-20.4) vs 21.0 (18.4-23.8),
p<0.001. There was no systematic relationship between RNFLT and visual acuity, cup-to-disc ratio,
IOP, central corneal thickness, Humphrey mean deviation, and pattern standard deviation in either
group.
Conclusions: Compared to control eyes, polarimetry-determined RNFLT was lower in XFS eyes with
normal IOP. Therefore, close monitoring of RNFLT may facilitate early identification of those XFS eyes
that convert to exfoliative glaucoma.
Keywords: Exfoliative glaucoma, Exfoliation syndrome, GDx-VCC, Retinal nerve fiber layer thick-
ness, RNFLT, Scanning laser polarimetry
Accepted: January 4, 2013
ORIGINAL ARTICLE
DOI: 10.5301/ejo.5000247
INTRODUCTION
Exfoliation syndrome (XFS) is an age-related condition
characterized by the gradual synthesis and accumulation
of a fibrillar extracellular material in many ocular and ex-
traocular tissues (1, 2). It is the most common identifiable
cause of open-angle glaucoma worldwide, comprising the
majority of glaucoma cases in several countries (3). Exfo-
liation syndrome and exfoliative glaucoma (XFG) currently
affect 60-70 million people worldwide (1, 3). Eyes with XFS