Abstract
Purpose :
The long anterior zonule (LAZ) trait is characterized by anomalous zonule-like fibers present on the anterior lens capsule central to the normal zonule insertion zone. At least two varieties have been described. One rare type is associated with late-onset retinal degeneration (L-ORD) and caused by a S163R mutation in the C1q tumor necrosis factor-related protein 5 gene (C1QTNF5/CTRP5). The other variety is idiopathic, may have prevalence near 2%, and has predilection for hyperopic females with age >50 years. Both varieties may exhibit pigment dispersion, and there is potential association with glaucoma. With an ongoing study, we report further on potential health associations with LAZ.
Methods :
Several practitioners in an urban, academic primary eye care center in Chicago, IL, USA evaluated consenting patients for LAZ from 2011 to 2018. To supplement clinical findings, questionnaires were used to obtain information related to lifestyle and demographics. Variables assessed included ocular and general health status, education, smoking, alcohol use, and height/weight for calculation of body mass index. Multivariate logistic regression was used to assess relationships to LAZ presence.
Results :
The analysis included 3,494 total subjects (65.0% female, 82.3% African American), with mean age of 50.6 ± 15.4 years (18-98 years). Subjects with >trace LAZ in either eye (N=131, 80.2% female, 90.8% African American) with mean age of 63.4 ± 11.7 years (35-92 years). Mean sphere-equivalent refractive error of LAZ subjects was +0.48D ± 2.28D (-10.44D to 7.69D) vs. -0.94D ± 2.8D (-28.38D to 7.56D) for those without LAZ. Controlling for age, female gender, and hyperopic refractive error, strongest associations occurred with elevated body mass index, hypertension, and smoking in packyears (P<0.05). In addition, there was strong association with non-asthma-related lung disease, with LAZ subjects being 2.5x (OR=2.52; 95% CI=1.35 to 4.72, P=0.004) more likely to exhibit lung disease than people without LAZ.
Conclusions :
In addition to strong associations with age, female gender, and hyperopic refractive error, this analysis further suggests LAZ has relationship to adverse health factors including elevated body mass index, hypertension, history of smoking and non-asthma-related lung disease.
This is a 2021 ARVO Annual Meeting abstract.