March 2012
Volume 53, Issue 14
ARVO Annual Meeting Abstract  |   March 2012
Persistent Pupillary Membranes and Long Anterior Zonules
Author Affiliations & Notes
  • Daniel K. Roberts
    Clinical Education, Illinois College of Optometry, Chicago, Illinois
    Epidemiology and Biostatistics,
    University of Illinois at Chicago, Chicago, Illinois
  • Jacob T. Wilensky
    Ophthalmology and Visual Sciences,
    University of Illinois at Chicago, Chicago, Illinois
  • Footnotes
    Commercial Relationships  Daniel K. Roberts, None; Jacob T. Wilensky, None
  • Footnotes
    Support  NEI Grant K23 EY0181883
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 5059. doi:
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      Daniel K. Roberts, Jacob T. Wilensky; Persistent Pupillary Membranes and Long Anterior Zonules. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5059.

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      © ARVO (1962-2015); The Authors (2016-present)

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Long anterior zonules (LAZ), characterized by zonular fibers that extend more central than usual on the anterior lens capsule, may cause a unique type of intraocular pigment dispersion, and there is question whether there is association with open- and narrow-angle forms of glaucoma. Although one variety of LAZ can occur with late-onset retinal degeneration (L-ORD) resulting from a C1QTNF5/CTRP5 mutation, the etiology of a more common variety not associated with L-ORD and usually detected in people >50 years old, is unknown. Age-related phenomena vs. alternative gene mutation(s) are possible explanations. This study investigated evidence for coexisting developmental anomaly in people with the age-associated LAZ phenotype.


As part of a larger investigation of the LAZ trait, African-American LAZ subjects and matched controls had extensive ocular evaluation that included standardized retro-illumination photographic documentation of the crystalline lens through a dilated pupil. For this sub-investigation, the frequency of persistent pupillary membranes (PPM) characterized by iris-to-iris attachment with extension across a portion of the pupil was compared between LAZ cases and controls.


There were 77 LAZ subjects (mean age=69.3 +/- 9.7 yrs, 48 to 92 yrs; 67 females/10 males) and 76 controls (mean age=67.8 +/- 9.0 yrs, 50 to 93 yrs; 65 females/11 males) in the analysis. For right eyes, 18 of 76 (23.4%) LAZ subjects had PPMs vs. 8 of 76 (10.5%) for controls. Among left eyes, 17 of 76 (22.1%) LAZ subjects had PPMs vs. 8 of 76 (10.5%) for controls. Among LAZ subjects 12 of 75 (16%) had PPMs in both eyes vs. 5 of 76 (6.6%) for controls. Controlling for age, subjects with LAZ were 2.8 times more likely to exhibit PPMs than subjects without LAZ (OR=2.8; 95% CI=1.1 to 6.9; P<0.05). Similar results were found for left eyes.


LAZ subjects were more likely to have PPMs than controls, which may suggest the presence of anterior segment dysgenesis that may affect multiple intraocular structures.

Keywords: anterior segment • iris • clinical (human) or epidemiologic studies: prevalence/incidence 

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