Impact of Valsalva Maneuver on Central Corneal Thickness, Anterior Chamber, Macular, Optic Nerve Parameters and Choroidal Thickness in Pseudoexfoliation Glaucoma Patients

Abstract

Purpose: To evaluate impact of Valsalva maneuver on central corneal thickness, anterior chamber parameters, optic nerve parameters and macular-choroidal thickness of pseudoexfoliation glaucoma (PEG) patients.Materials and Methods: Fifty-three eyes of 30 patients with PEG were included in this study between January 2017 and August 2017. All patients under went optic disc, retinal nerve fi ber layer (OD RNFL), central macular thickness (CMT) and subfoveal choroidal thickness (CT) measurements performed by Spectral Domain Optic CoherenceTomography (SD-OCT); irido corneal angle (ICA), anterior chamber depth(ACD), and central corneal thickness (CCT) measurements were performed with Sirius Scheimpfl ug-Placido Topographer before and during Valsalva maneuver (VM). Results: OD RNFL parameters were signifi cantly decreased during the VM (82.1±21.5 μm before VM, 81.6±21.2 μm during VM, p‹0.034). There were decrease in parameters of CMT (218.9±25 μm before VM, 217.5±24 μm during VM p=0.83), ICA (42.5°±9 before VM, 42.0°±9 during VM , p=0.188) and ACD (3.39±0.6 mm before VM, 3.38±0.6 mm during VM , p=0.082) but these impacts were not signifi cant. There was signifi cantly increase in parameters of subfoveal CT during VM (213.3±40.9 μm before and 224.0±40.0 μm during VM; p‹0.001 ). There was increase in parameters of CCT but this impactwas not significant (536.2±33.5 μm before VM , 537.5±35.8 μm during VM , p=0.237). Conclusions: The VM has some infl uence on corneal morphology and anterior chamber parameters, but they were not significant. The changes in RNFL and CT have to be in mind during patient examination due to thein fluence of VM.