July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
CROSS-SECTIONAL ANALYSIS OF RELATIONSHIP BETWEEN THE IDIOPATHIC LONG ANTERIOR ZONULE TRAIT AND GLAUCOMA OR OCULAR HYPERTENSION IN A CLINIC-BASED PRIMARY EYE CARE POPULATION
Author Affiliations & Notes
  • Daniel K Roberts
    Illinois College of Optometry, River Forest, Illinois, United States
    Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, Illinois, United States
  • Janice McMahon
    Illinois College of Optometry, River Forest, Illinois, United States
  • Christina Morettin
    Illinois College of Optometry, River Forest, Illinois, United States
  • Tricia L Newman
    Illinois College of Optometry, River Forest, Illinois, United States
  • Mary F Roberts
    Illinois College of Optometry, River Forest, Illinois, United States
  • Bruce A Teitelbaum
    Illinois College of Optometry, River Forest, Illinois, United States
  • Janis E Winters
    Illinois College of Optometry, River Forest, Illinois, United States
  • Footnotes
    Commercial Relationships   Daniel Roberts, None; Janice McMahon, None; Christina Morettin, None; Tricia Newman, None; Mary Roberts, None; Bruce Teitelbaum, None; Janis Winters, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 1815. doi:
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      Daniel K Roberts, Janice McMahon, Christina Morettin, Tricia L Newman, Mary F Roberts, Bruce A Teitelbaum, Janis E Winters; CROSS-SECTIONAL ANALYSIS OF RELATIONSHIP BETWEEN THE IDIOPATHIC LONG ANTERIOR ZONULE TRAIT AND GLAUCOMA OR OCULAR HYPERTENSION IN A CLINIC-BASED PRIMARY EYE CARE POPULATION. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1815.

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

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Abstract

Purpose : The long anterior zonule (LAZ) trait is characterized by zonular fibers extending central to the normal anterior capsular insertion zone. It is frequently accompanied by pigment dispersion signs, and is hypothesized to be associated with glaucoma. Rarely, LAZ may be caused by a S163R mutation in the C1q tumor necrosis factor-related protein 5 gene (C1QTNF5/CTRP5) in association with late-onset macular degeneration, but a more common variety is idiopathic with potential prevalence of 2% or higher. The purpose of this analysis was to investigate the relationship between LAZ and glaucoma.

Methods : As part of an ongoing investigation, ocular and general health information was collected during 2011-2017 on consecutive patients belonging to several practitioners in an urban academic eye care facility in Chicago, Illinois, USA. All patients were examined for the LAZ trait, and information on ocular, systemic health, lifestyle, and other demographic variables was collected from the medical record as well as from a questionnaire administered at time of exam. Patients were excluded if they were <18 years of age, refused consent, did not have pupil dilation, or if there was history of intraocular surgery, uveitis, or significant ocular trauma. Controlling for numerous factors, multivariate regression was used to explore the relationship between LAZ and presence of glaucoma or ocular hypertension.

Results : Analysis included 3,057 subjects (mean age=51.0 +/- 15.3 years, 84% African-American, 64.8% female), with 94 of these people having >trace LAZ in the right eye (mean age=64.3 +/- 11.0 years, 94.7% African-American, 78.7% female). Among non-LAZ eyes, 4.1% (N=119) were treated with glaucoma medications, and among LAZ eyes, 14.9% (N=14) were taking glaucoma medications (P<0.0001). Controlling for other significant factors (P<0.05), including age, race, refractive error, BMI, and history of smoking, the association between LAZ and use of glaucoma medications was retained (P<0.05), with LAZ eyes being 2.0x more likely (OR=2.0, 95%CI=1.1 to 3.9) to be treated with glaucoma medications than eyes not having LAZ.

Conclusions : This investigation supports the hypothesis that eyes with the LAZ trait may have elevated risk of glaucoma. Further study of this association is warranted.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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