Assessment of iris and anterior chamber angle in pseudoexfoliation patients: A comparative study

Abstract: PURPOSE: The purpose of this study was to deeply investigate the iris biomechanics in pseudoexfoliation syndrome (PEX) patients using anterior segment optical coherence tomography (AS-OCT). METHODS: The study included 34 patients (40 eyes) divided into two groups: 14 patients (20 eyes) with the PEX group and 10 participants (20 eyes) as a normal control group. All participants underwent a thorough ophthalmic examination. AS-OCT imaging was performed using an Avanti RTVue-XR platform, and measurements of angle, iris, and pupil diameter were calculated. RESULTS: AS-OCT measurements showed significantly narrower angle parameters in the PEX group, including smaller OCT angle degree (24.1° ± 8.41° vs. 35.3° ± 6.15°, P = 0.000024), reduced TISA 500 (0.118 ± 0.051 mm 2 vs. 0.211 ± 0.043 mm 2 , P < 0.0001), and smaller angle opening distance at 500 μm (324.65 ± 156.79 μm vs. 581.75 ± 122.62 μm, P < 0.0001). Pupil diameter was significantly smaller in the PEX group (2.73 ± 0.65 mm vs. 4.06 ± 0.75 mm, P < 0.0001). Iris parameters in PEX patients showed greater iris vault (218.8 ± 51.09 μm vs. 163.9 ± 48.28 μm, P = 0.0012), increased maximum iris thickness (554.1 ± 82.24 μm vs. 502.6 ± 78.48 μm, P = 0.0498), and shorter iris chord length (4.28 ± 0.61 mm vs. 4.76 ± 0.52 mm, P = 0.0118). CONCLUSION: The study confirms that PEX eyes exhibit significant structural alterations in iris biomechanics that are responsible for secondary glaucoma.