OPTIC DISK APPEARANCE IN PSEUDOEXFOLIATION SYNDROME

PURPOSE: To evaluate the optic disk appearance in eyes with pseudoexfo liation syndrome. METHODS: Clinical data and color stereo optic disk p hotographs of 99 patients with pseudoexfoliative glaucoma and 42 nongl aucomatous subjects with pseudoexfoliation syndrome were compared with those of 658 patients with primary open angle glaucoma and of 364 nor mal subjects. RESULTS: Mean optic disk area was significantly (P = .00 9) smaller in the pseudoexfoliative glaucomatous eyes (mean +/- SD, 2. 52 +/- 0.49 mm(2)) than in the primary open angle glaucoma eyes (2.71 +/- 0.63 mm(2)). Correspondingly, mean optic disk area was significant ly (P = .04) smaller in the pseudoexfoliative nonglaucomatous eyes (2. 48 +/- 0.52 mm(2)) compared with the normal eyes without pseudoexfolia tion (2.61 +/- 0.67 mm(2)). Comparing the pseudoexfoliative subgroups with the non pseudoexfoliative subgroups separately in the glaucomatou s and the nonglaucomatous groups, no significant differences were foun d for neuroretinal rim area, size of alpha and beta zones of the parap apillary atrophy, and diameters of the retinal arterioles and venules at the disk border. In the glaucomatous group, the maximal intraocular pres sure measurements were significantly (P < .001) higher in the ps eudoexfoliative subgroup than in the subgroup with primary open-angle glaucoma. CONCLUSIONS: Except for a slightly smaller optic disk, eyes with pseudoexfoliative glaucoma and eyes with primary open angle glauc oma do not vary significantly in their optic disk appearance despite s ignificantly higher intraocular pressure peaks in pseudoexfoliative gl aucoma. In eyes with pseudoexfoliation syndrome, a small optic disk do es not predispose to glaucoma. In contrast with the anterior segment o f the eye, the optic disk does not show pathognomonic features for pse udoexfoliation.