Abstract
Purpose :
The long anterior zonule (LAZ) trait is characterized by aberrant zonular fibers central to the usual anterior capsular insertion zone. Pigment dispersion occurs with LAZ, which may be confused with primary, or classic, pigment dispersion syndrome. Evidence suggests that eyes with LAZ have higher intraocular pressure on average than eyes without LAZ, and there is suggestion of association with glaucoma. Rarely, LAZ may be caused by an S163R mutation in the C1q tumor necrosis factor-related protein 5 gene (C1QTNF5/CTRP5) in association with late-onset retinal degeneration (L-ORD), but usually it is idiopathic, with suggested prevalence near 2%. Although retinal/macular degeneration is prominent with the S163R C1QTNF5 mutation-related LAZ, there are no reports on retinal status among people with idiopathic LAZ.
Methods :
Consecutive patients of eight practitioners in an urban, primary eye care teaching setting in Chicago, IL, USA were checked for LAZ during 2011-2018, and detailed data were collected on ocular/systemic health, lifestyle, and demographic variables. All patients had comprehensive eye examination, including dilated retinal evaluation. Analysis was performed to assess retinal status on the subjects.
Results :
Among 3,592 tested,136 (3.8%) had LAZ, which had a LAZ/non-LAZ distribution that was 91.9%/83.2% African-American, 5.2%/7.5% Hispanic, 1.5%/5.8% White, 0.0%/2.0% Asian; 80.2%/64.2% female; mean age (SD), 63.3(11.8) / 50.3(15.4) years. LAZ was bilateral in 78% of subjects (12%/10% right/left eye only). Macular degeneration of any degree was reported in only 0.3% of control subject right/left eyes, but no LAZ eyes had evidence of macular or generalized retinal degeneration (P>0.5). When controlling for multiple factors, there was a tendency for people with diabetes and LAZ to more frequently have diabetic retinopathy, but this was marginally not significant (LAZ right eyes and retinopathy in either eye, OR=1.8, 95% CI=1.0 to 3.4, P=0.06; LAZ left eyes and retinopathy in either eye, OR=2.1, 95% CI=1.0 to 4.4, P=0.05).
Conclusions :
In this relatively large sample of predominantly African-American LAZ subjects, there was no evidence for retinal or macular degeneration resembling that reported in families with LAZ, L-ORD, and C1QTNF5 mutation. More study should be done to assess potential relation between LAZ and diabetic retinopathy.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.