Choroidal Vascularity Index Alterations across the Spectrum of Pseudoexfoliation Disease and Healthy Eyes

Purpose: To compare the macular choroidal vascularity index (CVI) among patients diagnosed with pseudoexfoliative glaucoma (PXG), pseudoexfoliation syndrome (PEX), and healthy individuals. Methods: A cross-sectional analysis was conducted involving 77 eyes with PXG, 28 with PEX, and 74 from healthy controls. Enhanced depth imaging optical coherence tomography scans of the macula were analyzed using ImageJ software. The CVI was obtained by calculating the proportion of the luminal area within the total choroidal area. Generalized linear models were employed for statistical evaluation. Results: Subjects in the PXG and PEX groups were significantly older than those in the control group ( P < 0.001), and sex distribution also differed significantly ( P < 0.05). Eyes with PXG exhibited a notably lower CVI than normal eyes (0.62 ± 0.03 vs. 0.64 ± 0.04, P = 0.001). The difference between the PEX and control groups was not statistically significant ( P = 0.146). After adjusting for age, sex, and axial length , the difference in CVI between PXG and controls did not reach statistical significance ( P = 0.094). Conclusions: PXG may be associated with reduced CVI in the macular region, suggesting potential choroidal vascular alterations. This warrants further investigation into the vascular aspects of PXG pathophysiology.