Possible association between long anterior lens zonules and plateau iris configuration.
ABSTRACT To report plateau iris configuration (PIC) in subjects who have the long anterior zonule (LAZ) clinical trait.
Two elderly African American males who exhibited LAZ and had partial appositional angle closure persisting after laser iridotomy were imaged with high-resolution ultrasonography to examine for PIC. A third elderly LAZ subject who had narrow angles without closure was also imaged for PIC. Each subject was tested for a serine 163 arginine mutation (S163R) C1q tumor necrosis factor-related protein 5 gene (C1QTNF5/CTRP5) mutation, which may be associated with the LAZ phenotype.
All 3 LAZ subjects also had PIC, an unlikely association due to chance alone. None carried the S163R CTRP5 mutation.
LAZ and PIC may have association and require study because LAZ might be a useful indicator for an increased likelihood of PIC and risk of angle closure. Mutation other than CTRP5 S163R should also be considered for the LAZ trait, which could be an important phenotypic marker in genetic studies.
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ABSTRACT: To investigate the relationship of Krukenberg spindles (KS) and pigmented lens striae (PLS), clinical signs related to iris pigment dispersal and possibly glaucoma. During a 31-month period, 5 practitioners in an urban, primary eye care setting examined consecutive patients for KS and PLS. Multiple logistic regression was used to evaluate relationships among KS, PLS, and other variables. Krukenberg spindles were present in 65 patients (52 females), comprised of 57 of 2647 (2.2%) blacks, 5 of 303 (1.7%) whites, 2 of 121 (1.7%) Hispanics, and 1 of 55 (1.8%) Asians. PLS were present in 64 subjects (56 females), comprised of 59 (2.2%) blacks, 3 (1.0%) whites, and 2 (3.6%) Asians. KS and PLS were coexistent in 27 subjects. Mean age +/- SD (range) of the KS and PLS subjects was 63.1 +/- 15.0 years (24-88 years) and 67.0 +/- 10.4 years (33-88 years), respectively. Mean refractive error +/- SD (range) of KS and PLS right eyes was +0.55 +/- 2.32D (-6.50 to +5.50D) and +1.34 +/- 2.18D (-6.50 to +7.25D), respectively. Controlling for other variables, PLS were highly predictive (OR = 30.2, P < 0.0001) of KS, and KS were highly predictive (OR = 29.5, P < 0.0001) of PLS. Ignoring presence or absence of PLS, increasing age (in decades) (OR = 1.60, P < 0.0001) was strongly associated with KS. Ignoring presence or absence of KS, age (OR = 1.74, P < 0.0001), female gender (OR = 2.96, P = 0.009), and increasing hyperopic refractive error (OR = 1.30, P < 0.0001) were strongly associated with PLS. Krukenberg spindles and PLS were strongly associated in our patient population, and the likelihood of both increased with increasing age. Female gender and increasing hyperopic refractive error were highly significant predictors of PLS.Journal of Glaucoma 02/2005; 14(1):57-63. · 1.87 Impact Factor
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ABSTRACT: To describe pigment dispersion associated with long anterior zonules. Multicenter observational case series. Fifteen patients, seven of whom were treated for glaucoma or ocular hypertension, were identified with long anterior zonules and pigment dispersion. Transmission electron microscopy was performed on one anterior capsule specimen. All patients had anterior zonules that inserted centrally on the lens capsule. Signs of pigment dispersion included corneal endothelial pigmentation, loss of the pupillary ruff, and variable trabecular meshwork pigmentation. Ultrasound biomicroscopy verified the lack of posterior iris insertion and concavity. There was no exfoliation material. Transmission electron microscopy showed zonular lamellae with adherent pigment granules, and no exfoliation material. Long anterior zonules inserted onto the central lens capsule may cause mechanical disruption of the pigment epithelium at the pupillary ruff and central iris leading to pigment dispersion.American Journal of Ophthalmology 01/2004; 136(6):1176-8. · 3.63 Impact Factor
- Acta ophthalmologica 02/1958; 36(3):419-23. · 2.44 Impact Factor