Fekrazad Sepehr, Gouravani Mahdi, Hassanzadeh Golnar, Mafhoumi Asma, Mirzad Mina, S Vafa Saeed, Xu Benjamin, Arevalo J Fernando
Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA.
International Network for Photomedicine and Photodynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN).
J Glaucoma. 2025 Jul 1;34(7):507-519. doi: 10.1097/IJG.0000000000002571. Epub 2025 Mar 25.
This meta-analysis demonstrates significant thinning of the choroid and lamina cribrosa in eyes with pseudoexfoliation syndrome and pseudoexfoliative glaucoma compared with healthy controls, emphasizing OCT's potential utility for early glaucoma detection in these patients.
Pseudoexfoliation syndrome (PXS) is a significant risk factor for pseudoexfoliative glaucoma (PXG), impacting posterior segment tissues such as the choroid and lamina cribrosa (LC). This research aims to investigate the effects of PXS on these layers compared with healthy controls using optical coherence tomography (OCT).
Following the PRISMA checklist, this systematic review, registered at PROSPERO (CRD42023415302), examined OCT measurements in PXS and PXG patients. Searches were conducted in PubMed, Scopus, and EMBASE until April 2023. Selection criteria included human observational studies assessing choroid and lamina cribrosa layers with OCT in PXS and PXG patients. Statistical analyses, including meta-analysis, bias detection, subgroup analysis, and metaregression, were performed.
A total of 22 studies, comprising 2293 participants (717 PXG patients, 708 PXS patients, and 868 healthy controls), underwent meta-analysis. In PXG cases, subfoveal choroidal thickness (CT), as well as CT at 1500 µm and 3000 µm temporal and nasal to the fovea, were significantly decreased compared with healthy individuals. In addition, average peripapillary CT and average LCT were significantly reduced in PXG eyes compared with healthy controls. Similarly, eyes with PXS exhibited significantly lower values for subfoveal CT, CT at 1500 µm temporal and 3000 µm nasal to the fovea, average peripapillary CT, and average LC thickness compared with healthy controls.
This meta-analysis confirms previously reported decreases in CT and LC thickness in patients with PXG and PXS. Continuous monitoring of choroid and LC using OCT may facilitate the early detection of glaucoma in patients with PXS, addressing a key concern in their management.
这项荟萃分析表明，与健康对照组相比，假性剥脱综合征和假性剥脱性青光眼患者的脉络膜和筛板显著变薄，强调了光学相干断层扫描（OCT）在这些患者早期青光眼检测中的潜在效用。
假性剥脱综合征（PXS）是假性剥脱性青光眼（PXG）的一个重要危险因素，会影响脉络膜和筛板（LC）等眼后段组织。本研究旨在使用光学相干断层扫描（OCT），比较PXS与健康对照组对这些层面的影响。
遵循PRISMA清单，本系统评价在PROSPERO（CRD42023415302）注册，研究了PXS和PXG患者的OCT测量结果。截至2023年4月，在PubMed、Scopus和EMBASE中进行了检索。选择标准包括评估PXS和PXG患者脉络膜和筛板层的人类观察性研究，并使用OCT进行分析。进行了统计分析，包括荟萃分析、偏倚检测、亚组分析和元回归分析。
总共22项研究，包括2293名参与者（717名PXG患者、708名PXS患者和868名健康对照）进行了荟萃分析。在PXG病例中，与健康个体相比，黄斑中心凹下脉络膜厚度（CT）以及黄斑中心凹颞侧和鼻侧1500μm和3000μm处的CT均显著降低。此外，与健康对照组相比，PXG患眼中的平均视乳头周围CT和平均LC厚度显著降低。同样，与健康对照组相比，PXS患者的黄斑中心凹下CT、黄斑中心凹颞侧1500μm和鼻侧3000μm处的CT、平均视乳头周围CT和平均LC厚度值均显著降低。
这项荟萃分析证实了先前报道的PXG和PXS患者CT和LC厚度降低。使用OCT持续监测脉络膜和LC可能有助于PXS患者青光眼的早期检测，这是其管理中的一个关键问题。
