Pseudo exfoliative glaucoma (PEXG) is a sight-threatening disease that develops resulting from Pseudo-exfoliation syndrome (PEX). The clinical impact of the diagnosis of early glaucomatous change can be understood. About 30-50% of retinal ganglion cells may be lost before any visual field changes are detected due to the deposition of PEX material. Some studies have reported the presence of difference in RNFL thickness measurement between the eyes with the PEX. The purpose of this study was to evaluate the RNFL thickness using SD-OCT system among the patients with PEX in comparison with patients affected with PEXG attending OPD clinic in the department of ophthalmology in IGMC Shimla. Patients having pseudo-exfoliation with glaucoma showed significant visual field defects as compared to their counterparts (p<0.001). The overall mean RNFL Thickness(µm) in the two groups was 89.47±13.52 µm and 72.73±13.54 µm and the difference between the means of RNFL thickness between the two groups was found to be statistically significant (p<0.001). Measurement of RNFL thickness in early stages of Pseudo-exfoliation with glaucoma can help to modify the course of management.

Pseudoexfoliation (PEX) is an age-related idiopathic condition characterized by progressive production and accumulation of extracellular matrix fibrillary material in the intraocular and extraocular tissues. Ocular involvement in PEX primarily manifests with anterior segment findings. The objective of the study was to estimate the retinal nerve fibre layer (RNFL) thickness in patients of pseudoexfoliation with (PEXG) and without glaucoma (PEX) by optical coherence tomography (OCT) and determine the corneal endothelial morphometric changes by Non-contact Specular Microscope in patients of pseudoexfoliation with (PEXG) and without glaucoma (PEX). This cross-sectional analytical study was conducted in the Department of Ophthalmology, Indira Gandhi Medical College, Shimla among the selected patients of pseudoexfoliation with and without glaucoma over a period of one year. We included normal healthy controls without any glaucomatous optic disc damages and an IOP <21 mmHg in group 1, patients clinically diagnosed as pseudoexfoliation without glaucoma (PEX) in group 2, and Patients already diagnosed as pseudoexfoliative glaucoma(PEXG) in group 3. RNFL thickness was significantly decreased in PEX and PEXG patients and endothelial cell density was decreased, pleomorphism and polymegathism of cells were increased, and pseudo exfoliative materials were precipitated in endothelial cells of PEX & PEXG eyes.