Peripapillary and Macular Vessel Density Measurement with Optical Coherence Angiography in Exfoliation Syndrome.

PRECIS Although peripapillary retinal nerve fiber layer thickness and vessel density (VD) values [ZERO WIDTH SPACE][ZERO WIDTH SPACE]were similar to healthy group, eyes with exfoliation syndrome had significantly lower superficial macular VDs and minimum ganglion cell analysis values. PURPOSE To compare peripapillary and macular perfused capillary densities with optical coherence tomography angiography (OCT-A) between patients with eyes having exfoliation syndrome (XFS) and normal age-matched healthy controls. PATIENTS AND METHODS This cross-sectional study included patients diagnosed with XFS during December 2017-January 2020 at the Glaucoma Department. Peripapillary and parafoveal superficial vessel densities (VDs) were obtained using OCT-A. The retinal nerve fiber layer thicknesses (RNFLTs) and ganglion cell analysis values were compared. RESULTS Thirty-nine eyes of 39 XFS patients (26 women; mean age, 69.0±8.1▒y) and 39 eyes of 39 healthy patients (25 women; mean age, 68.0±8.6▒y) were enrolled. There were no statistically significant differences in sex or age distribution, central corneal thickness measurements, refractive errors, or intraocular pressures between both groups (all P>0.05). There were no statistically significant differences in the peripapillary VD or peripapillary RNFLT between XFS eyes and healthy eyes (P>0.05 for all). In the macular region, most superficial VD parameters were significantly reduced in the XFS group (P=0.02 for parafoveal VD, P=0.04 for both hemifields). While the average ganglion cell and internal plexiform layer (GCL+IPL) values were similar between groups (P=0.19), the minimum GCL+IPL value was lower in the XFS group than in the healthy group (P=0.03). CONCLUSION Although structural test results, especially peripapillary RNFLT and mean GCL+IPL, were similar between the healthy and XFS groups, macular VD values were lower in XFS eyes. Our findings implicate microvascular damage can be the mechanism underlying XFS-related changes and indicate that it precedes significant structural damage.