Faria Pereira Ana, Mota Moreira Pedro, Coelho-Costa Inês, Teixeira-Martins Rita, Estrela Silva Sérgio, Oliveira-Ferreira Cláudia
Department of Ophthalmology, Unidade Local de Saúde de São João, Avenida Prof. Hernâni Monteiro, 4202-451, Porto, Portugal.
Department of Sense Organs, Faculty of Medicine, University of Porto, Porto, Portugal.
Sci Rep. 2025 Apr 4;15(1):11576. doi: 10.1038/s41598-025-95082-y.
Pseudoexfoliation (PEX) syndrome is a systemic disorder characterized by the accumulation of fibrillar material in ocular and extraocular tissues, primarily affecting the eye's anterior segment. While PEX is a known risk factor for open-angle glaucoma, its impact on retinal structures is less understood. This study aims to evaluate macular, circumpapillary retinal nerve fiber layer (cRNFL), and choroidal thickness in PEX patients without glaucoma. This cross-sectional study involved two groups: PEX group and a control group, both without glaucoma damage and with intraocular pressure (IOP) below 19 mmHg. Participants underwent full ophthalmic evaluations. Spectral-domain optical coherence tomography (SD-OCT) was used to measure cRNFL, macular, Bruch's membrane opening-minimum rim width (BMO-MRW), and choroidal thickness. A total of 60 eyes were included: 38 with PEX and 22 controls. Demographic and clinical characteristics were similar across groups. PEX group had a thinner nasal-inferior cRNFL compared to the control group (p < 0.05). Furthermore, PEX group exhibited significantly reduced thickness in superior, inferior, nasal-inferior, nasal-superior, and total ganglion cell layer (GCL), as well as in nasal-inferior, nasal-superior, and total inner plexiform layer (IPL) compared to the control group (p < 0.05). BMO-MRW thickness tended to be thinner across all sectors in PEX group, although no significant differences were found (p > 0.05). Regarding choroidal thickness, the temporal site was significantly thicker in PEX group (p < 0.05). This study highlights a significant association between PEX syndrome and the thickness reduction of the GCL and IPL, suggesting that these retinal changes could serve as early indicators of glaucoma or reflect broader neurodegenerative processes. Findings also reveal reduced cRNFL thickness in PEX eyes, further supporting the potential for early glaucomatous damage detection. These findings underscore the need for long-term studies to explore PEX-related neurodegeneration and its possible links to broader neurological conditions.
假性剥脱（PEX）综合征是一种全身性疾病，其特征是在眼内和眼外组织中积聚纤维状物质，主要影响眼球前段。虽然PEX是开角型青光眼的已知危险因素，但其对视网膜结构的影响尚不太清楚。本研究旨在评估无青光眼的PEX患者的黄斑、视盘周围视网膜神经纤维层（cRNFL）和脉络膜厚度。这项横断面研究涉及两组：PEX组和对照组，两组均无青光眼损害且眼压（IOP）低于19 mmHg。参与者接受了全面的眼科评估。使用光谱域光学相干断层扫描（SD-OCT）测量cRNFL、黄斑、布鲁赫膜开口最小边缘宽度（BMO-MRW）和脉络膜厚度。共纳入60只眼：38只患有PEX，22只为对照。两组的人口统计学和临床特征相似。与对照组相比，PEX组鼻下cRNFL更薄（p < 0.05）。此外，与对照组相比，PEX组在上、下、鼻下、鼻上和总神经节细胞层（GCL）以及鼻下、鼻上和总内丛状层（IPL）的厚度均显著降低（p < 0.05）。PEX组所有象限BMO-MRW厚度均有变薄趋势，但未发现显著差异（p > 0.05）。关于脉络膜厚度，PEX组颞侧部位明显更厚（p < 0.05）。本研究强调了PEX综合征与GCL和IPL厚度降低之间的显著关联，表明这些视网膜变化可能是青光眼的早期指标或反映更广泛的神经退行性过程。研究结果还显示PEX眼的cRNFL厚度降低，进一步支持了早期青光眼损害检测的可能性。这些发现强调了进行长期研究以探索PEX相关神经退行性变及其与更广泛神经系统疾病可能联系的必要性。
