J Korean Ophthalmol Soc.  2014 Jan;55(1):133-137.

A Case of Long Anterior Lens Zonule and Pigment Dispersion Syndrome

• Jeong JH
• Kim SG
• Lee HJ
• Lee SH
• Cha DM

Abstract

PURPOSE
To report a case of long anterior lens zonule and pigment dispersion syndrome.
CASE SUMMARY
A 67-year-old female visited our clinic with complaint of visual disturbance in the left eye. She had no history of nyctalopia. Visual acuity was 0.6 in the right eye and 0.4 in the left eye. Intraocular pressure was 12 mm Hg in the right eye and 16 mm Hg in the left eye. Nuclear sclerosis was observed in the left lens. There was no pseudoexfoliative material observed. In the left eye, long anterior zonules with brown pigmented lens striae were spotted irregularly in every direction of the anterior lens. On gonioscopy, the angle was open, and dense, uniform, trabecular meshwork pigmentations were observed at the interior 120 degrees. On fundus examination, cup-to-disc ratio was 0.4 in the right eye, 0.3 in the left eye, and multiple hard exudates were observed in both retinas. Axial length was 22.03 mm in the right eye and 21.84 in the left eye. Anterior chamber depth was 2.71 mm in the right eye and 2.47 mm in the left eye. Defects in the retinal nerve fiber or visual field examination were not observed and pigment dispersion syndrome was diagnosed. The patient showed no significant change at the 9-month follow-up.
CONCLUSIONS
We diagnosed atypical pigment dispersion syndrome associated with long anterior zonules and pigmented lens striae. Late onset retinal degeneration should be ruled out with chromosomal analysis if patients show nyctalopia, retinal pigment epithelium atrophy, or family history.

Keyword

Late-onset retinal degeneration; Long anterior lens zonule; Pigment dispersion syndrome; Pigmented lens striae

MeSH Terms

Aged
Anterior Chamber
Atrophy
Exudates and Transudates
Female
Follow-Up Studies
Gonioscopy
Humans
Intraocular Pressure
Nerve Fibers
Night Blindness
Pigmentation
Retina
Retinal Degeneration
Retinal Pigment Epithelium
Retinaldehyde
Sclerosis
Trabecular Meshwork
Visual Acuity
Visual Fields
Retinaldehyde

Figure

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  Figure 1. Anterior segment photos of the left eye shows prom-inent long anterior lens zonules (black arrows) causing a zon-ule-free zone (dotted circle) only 2.5 mm in diameter. At the proximal insertion area of long anterior zonular fibers, several heavily pigmented granules are clustered in the lower picture.

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  Figure 2. Inferior gonioscopy photograph of the left eye shows that the angle is open, and that the dense uniform trabecular meshwork pigmentations are observed at the lower 120 degrees.

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  Figure 3. Fundus photographss of the patient do notes not show glaucomatous cupping or retinal nerve fiber layer defect. Multiple hard exudates are observed in the both retinas, which are regarded as senile degenerative changes.

Reference

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