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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Anatomic Studies

Background:

  • Long anterior zonules (LAZ) are a rare ocular anomaly.
  • The association between LAZ and angle closure disease requires further investigation.

Purpose of the Study:

  • To characterize eyes with LAZ presenting to a glaucoma clinic.
  • To elucidate the pathogenesis of angle closure disease in eyes with LAZ.

Main Methods:

  • Retrospective cross-sectional study of 177 patients with LAZ (2014-2018).
  • LAZ eyes compared with age- and sex-matched controls.
  • Biometric parameters including anterior chamber depth, axial length, and lens thickness were analyzed.

Main Results:

  • Angle closure disease was present in 59.3% of LAZ eyes, primarily as primary angle closure suspects (PACS) or primary angle closure.
  • LAZ eyes demonstrated significantly increased lens thickness (LT), shallower anterior chamber depth (ACD), shorter axial length (AXL), and higher lens thickness to axial length factor (LAF) compared to controls.
  • Specific differences noted: LT (4.8 vs. 4.49 mm), ACD (2.68 vs. 3.0 mm), AXL (22.37 vs. 22.94 mm), LAF (2.14 vs. 1.96).

Conclusions:

  • More than half of eyes with LAZ present with angle closure disease.
  • LAZ eyes exhibit specific biometric characteristics predisposing to angle closure.
  • LAZ may serve as a clinical indicator for elevated risk of developing angle closure disease.