Exfoliation syndrome tied to thinner RNFL, GCC

Patients with unilateral exfoliation syndrome (XFS) show thinner retinal nerve fibre layer (RNFL) and ganglion cell complex (GCC) thicknesses, a recent study reports.

Researchers conducted a prospective case-control study on 54 eyes from 27 unilateral XFS patients (mean age, 73.3±6.3 years; 18 males) and 27 age-matched controls (mean age, 74.3±7.2 years; 20 males). Spectral domain optical coherence tomography was used in the measurement of RNFL and GCC thickness after pupillary dilation, and findings were compared between groups.

One-way analysis of variance (ANOVA) found a borderline-significant difference in RNFL thickness between XFS eyes and controls (p=0.057). Upon post-hoc analysis, this discrepancy grew, such that those with XFS showed slightly but significantly thinner RNFL than controls (p=0.014).

This was particularly evident in the superior quadrant of the RNFL, which was significantly thinner in XFS vs control eyes (108.5±13.5 vs 114.3±12.2 µm) by both ANOVA (p=0.002) and after Tukey’s post-hoc test (p=0.001).

One-way ANOVA also found a significant difference in average GCC thickness between XFS and control patients (p=0.032). Specifically, superior GCC thickness was reduced in both XFS and fellow eyes than in healthy control eyes (86.1±6.5 and 87.8±6.3 vs 94.6±5.7 µm; p=0.001 and p=0.004, respectively, by Tukey’s post-hoc test). The inferior GCC quadrant showed no such difference (p=0.125).

The findings suggest that the “[d]iagnosis of XFS itself might predict thinning of the retina and could be a risk factor for development of a glaucomatous optic disc and retinal nerve fibre layer damage,” researchers said.