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| OPHTHALMIC IMAGE |
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| Year : 2023 | Volume
: 3
| Issue : 2 | Page : 613 |
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Long anterior zonules-associated pigment dispersion
Rajalakshmi Selvaraj, Janani Rajagopal, Niruban Ganesan
Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| Date of Web Publication | 28-Apr-2023 |
Correspondence Address:
Janani Rajagopal
Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Karaikal, Puducherry
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/IJO.IJO_3238_22
How to cite this article:
Selvaraj R, Rajagopal J, Ganesan N. Long anterior zonules-associated pigment dispersion. Indian J Ophthalmol Case Rep 2023;3:613 |
A 52-year-old male presented with blurred vision in both eyes. Examination revealed bilateral persistent pupillary membrane [Figure 1]a, Krukenberg's spindle [Figure 1]b, and immature cataract with normal intraocular pressure (IOP). Radial pigmented zonular fibers were noted over the anterior lens capsule [Figure 1]c, extending beyond the usual termination zone with a central zonule-free area. Open angles with pigmented trabecular meshwork were noted [Figure 1]d. Fundus was unremarkable, except for peripheral retinal drusen. Long anterior zonule (LAZ) has two phenotypes: type 1 is seen in young patients with late-onset retinal degeneration (LORD)[1] and type 2 is seen in older hypermetropic patients.[2] This rare entity serves as a surrogate marker for underlying sight-threatening diseases like glaucoma[3] and retinal degeneration and cautions the surgeon for a meticulous capsulorhexis. | Figure 1: Long anterior zonules. (a) Slit-lamp photograph showing persistent pupillary membrane across the pupil. (b) Slit-lamp photograph showing Krukenberg's spindle in the corneal endothelium. (c) Slit-lamp photograph showing pigmented long anterior zonules over the anterior lens capsule (black arrow) with Krukenberg's spindle. (d) Gonioscopy image showing wide open angle with granular pigment dispersion over trabecular meshwork (black arrow)
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Declaration of patient consent
We certify that we have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal his identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Subrayan V, Morris B, Armbrecht AM, Wright AF, Dhillon B. Long anterior lens zonules in late-onset retinal degeneration (L-ORD). Am J Ophthalmol 2005;140:1127-9.  |
| 2. | Roberts DK, Ayyagari R, McCarthy B, Xie H, Davis F, Wilensky JT. Investigating ocular dimensions in African Americans with long anterior zonules. J Glaucoma 2013;22:393-7. |
| 3. | Newman TL, Roberts DK, Morettin CE, McMahon JM, Roberts MF. Krukenberg's spindles strongly suggest long anterior zonule associated pigment dispersion mechanism in older patients. Invest Ophthalmol Vis Sci 2020;61:8. |
[Figure 1]
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