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PRECIS: This cross-sectional study of 20 patients with primary open-angle glaucoma, 20 with exfoliative glaucoma, 20 with exfoliation syndrome showed that exfoliative group had a significantly lower smell identification level as compared with the control groups. PURPOSE: To investigate smell sensitivity in primary open-angle glaucoma (POAG), exfoliative glaucoma (XFG) and exfoliation syndrome (XFS) in comparison with healthy controls. MATERIALS AND METHODS: This prospective, cross-sectional study included 20 patients with POAG, 20 with XFG, and 20 with XFS. The control group coonsisted of 20 age- and sex- matched healthy subjects with no evidence of ocular disease. The Sniffin' Sticks smell test was used to determine the, threshold values, and to assess the ability of smell identification, and differentiation in all patients One eye per patient was included for statistical purposes. One-way analysis of variance (ANOVA) was used to compare the differences between the groups. Tukey honestly significant difference (HSD) was used as a post-hoc test when significant differences were detected among the three groups. RESULTS: The XFG, POAG, and control groups showed a significant difference in the odor discrimination, odor identification, and threshold discrimination identification scores. The median (minimum-maximum) smell threshold levels for the POAG, XFG, and XFS groups and healthy controls were 4.5 (0-7.5), 4 (0-7.5), 5 (4.5-6), and 5.5 (4-7.5), respectively. The smell differentiation values for the POAG, XFG, and XFS groups and healthy controls were 12 (2-14), 8 (0-13), 11 (10-13), and 12 (9-14), respectively. Smell sensitivity for the POAG, XFG, and XFS groups and healthy controls were 26 (4-30.5), 19 (0-29.5), 28.3 (22.8-30.5), and 29 (26.5-32), respectively. The smell sensitivity and differentiation were significantly different among the groups (P<0.001). The XFG group had a significantly lower smell identification level than the POAG, XFS, and control groups. CONCLUSION: Patients with XFS and XFG revealed reduced smell sensitivity and identification compared to patients with POAG and those without glaucoma. These findings provide new insights into neural degeneration and pseudoexfoliation.
Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey Department of Otolaryngology, Hacettepe University Faculty of Medicine, Ankara, Turkey Department of Biostatistics, Hacettepe University School of Medicine, Ankara, Turkey University of Genoa, Laboratorio clinico anatomo-funzionale per diagnosi e il trattamento del glaucoma e della malattie neurooftalmologiche, Clinica Oculistica, Department of Neurological Sciences, Ophthalmology, Genetic, Italy.
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