Dense Pigmentation of the Posterior Lens Capsule Associated with the Pigment Dispersion Syndrome

The potential influence of the ligament of Wieger on the crystalline lens shape

This research uses mathematical modelling to evaluate the influence of the ligament of Wieger on the crystalline lens shape at rest, and during accommodation. An axisymmetric model of the anterior segment, including the ligament of Wieger, was created using the finite element method. Different conditions including variations of stiffness and positions of the ligament, with and without the ligament, were tested to see how they affected lens curvature and optical power. Adding the ligament of Wieger to the simulation had a noticeable impact on the optical power of the lens, particularly on the posterior surface power and total power. Ligament stiffness and width significant influenced the accommodative range of the eye by - 0.95D and - 2.39D for ligaments with the same and 3× the stiffness of the capsular bag, respectively. Ligament width and inner diameter had negligible effects on lens thickness but did have significant effects on posterior surface power and accommodation. In this simulation, we found that the ligament of Wieger can significantly affect the lens shape, both at rest and during accommodation, and may need to be considered in lens models.

Evaluation of Vitreolenticular Interface in Eyes with Fuchs Uveitis

PURPOSE

To investigate the vitreo-lenticular interface (Berger space) in Fuchs uveitis (FU).

METHODS

This cross-sectional study included 20 FU patients (Group 1), the fellow eyes of patıents (Group 2) and 20 healthy individuals (Group 3).

RESULTS

Berger space was detected in all, and hyperreflective spots were identified in Berger spaces in 65% of FU eyes through optical coherence tomography (OCT). The measurements of Berger space the distance in central, nasal, and temporal 2 mm were 715 ± 101μ, 620 ± 66μ, and 676 ± 76μ in group 1; 370 ± 40μ, 321 ± 41μ, 297 ± 39μ in group 2 and 290 ± 37μ, 267 ± 32μ, 227 ± 28μ in group 3. There was a statistical difference between groups 1, 2nd, and 3rd in all the values.

CONCLUSION

The detection of the Berger space is the crucial finding of this study. Visualizing the vitreolenticular area may reveal new insights for pathology and OCT-guided investigations.

Detection of Anterior Hyaloid Membrane Detachment Using Deep-Range Anterior Segment Optical Coherence Tomography

The visibility of anterior hyaloid membrane (AHM) and Berger’s space in phakic eyes was investigated. In 624 eyes of 624 patients, the retrolental space was scanned with the deep-range anterior segment optical coherence tomography (AS-OCT, CASIA2, Tomey). Subgroup analysis was conducted in 223 eyes undergoing cataract surgery. The logistic regression analysis using the backward-elimination method was performed to evaluate the influence of various factors on the visibility of AHM (dependent variable). Explanatory variables included age, gender, axial length, corneal power, corneal cylinder, and the Co III gradings. Intrarater repeatability for AHM visibility was excellent with the prevalence-adjusted bias-adjusted kappa (κ coefficient) of 0.90. AHM was observed in 43 eyes (6.9%). The patients with visible AHM (68.1 ± 8.8 years) were significantly older than those without visible AHM (52.6 ± 25.6 years) (p < 0.001). The logistic regression analysis in the cataract surgery subgroup revealed that axial length (p = 0.030) and corneal power (p = 0.043) were significantly associated with AHM visibility. The mean absolute refractive error from target was significantly larger in eyes with visible AHM (0.670 ± 0.384 D) than with invisible AHM (0.494 ± 0.412 D) (p = 0.037). The postoperative refractive prediction was less accurate in eyes with visible AHM, but no significant tendency existed in terms of myopic or hyperopic shifts.

A case of dense pigment deposition of the posterior lens capsule

BACKGROUND

Pigment dispersion syndrome (PDS) is a well-known entity which can lead to pigmentary glaucoma (PG). This case report presents a rare presentation of PG with bilateral dense pigment deposits of the posterior lens capsule.

CASE PRESENTATION

A 72-year-old male came for his first appointment due to an asymmetric worsening of visual acuity. The examination showed unilaterally severely increased intraocular pressure, bilateral dense pigment deposition of the posterior lens capsule, and a shallow unilateral optic disk excavation. Gonioscopy revealed moderate pigmentation of the angle and a concave configuration of the peripheral iris in both eyes. The standard slit lamp examination showed no transillumination defects of either iris. Optical coherence tomography showed retinal nerve fiber layer (RNFL) thinning in the peripapillary and macular regions. An antiglaucoma medication was prescribed with a good lowering effect.

CONCLUSION

Pigment deposition of the posterior lens capsule, which has been rarely reported, is a possible important sign of PDS or PG.

Curvilinear, symmetrical, and profound pigment deposition on the posterior lens capsule in a patient with bilateral pigmentary dispersion syndrome

Introduction

The classic presentation of pigmentary dispersion syndrome (PDS) often consists of midperipheral iris transillumination defects, Krukenberg’s spindle, and dense homogeneous trabecular pigmentation. Other subtle, sometimes overlooked features include pigment on the lens zonules, pigment on the anterior lens capsule and pigment along the equator of the posterior lens capsule.

Case

This unique presentation of PDS presented with bilateral, dense, oblique, and symmetrical pigment deposition along the posterior lens capsule that changed in shape, density, and extent over the span of 3 years.

Discussion

There have been few reports in the literature that describe a central accumulation of pigment along the posterior lens capsule associated with PDS. There are reported cases of pigment deposition along the central aspect of the posterior lens capsule, some changing over time, although none were bilateral and symmetrical. There are suggestions that perhaps this central pigment deposition is related to a break in the ligament of Weiger, allowing communication between the posterior chamber and posterior lens capsule. This is a case in which curvilinear, symmetrical, and changing pigment deposition on the posterior lens capsule is suggestive of perhaps another key features of PDS.

Real-Time Intraoperative Optical Coherence Tomography Imaging Confirms Older Concepts About the Berger Space

BACKGROUND

The presence of a space between the posterior capsule and the anterior vitreous was first reported in 1887, but difficulties inherent in examining this structure made it impossible to visualize this area in vivo until now. Estimation of the size of this space was considered to be impossible.

MATERIALS AND METHODS

We utilized an optical coherence tomography (OCT) system attached to the Zeiss Opmi Lumera 700/Rescan microscope (Zeiss Ltd., Jena, Germany) to provide real-time images of the Berger space, the anterior hyaloid and the ligament of Wieger.

RESULTS

Imaging in 3 patients provided beautiful, real-time OCT images of the Berger space and of the ligament of Wieger. In one highly myopic eye, there was even evidence of anterior vitreous detachment.

CONCLUSION

Previously unseen transparent structures of the eye can now be imaged intraoperatively using real-time OCT. This new technology seems very promising in achieving a better understanding of the anterior vitreous interface, more specifically of the anterior hyaloid and its posterior capsule attachment by the ligament of Wieger. Changes in the anterior hyaloid and its capsular attachment may contribute to a better understanding of the posterior segment complications after cataract surgery.

Central posterior capsule pigmentation in a patient with pigment dispersion and previous ocular trauma: a case report

We report a 55-year-old man with unusually dense, unilateral central posterior capsule pigmentation associated with the characteristic clinical features of pigment dispersion syndrome, including a Krukenberg's spindle and dense trabecular pigmentation in both eyes. A history of an old blunt ocular trauma probably caused separation of the anterior hyaloid from the back of the lens, thereby creating an avenue by which pigment could reach the potential space of Berger's from the posterior chamber.

Age-related changes in visual acuity, learning and memory in C57BL/6J and DBA/2J mice

The DBA/2J mouse is a model of age-related pigmentary glaucoma in humans. Visual detection, pattern discrimination and visual acuity were evaluated in DBA/2J, C57BL/6J, B6.mpc1d (a C57 congenic strain) and D2.mpc1b (a D2 congenic strain) mice at 6, 12, 18 and 24 months of age. Mice were also tested in the Morris Water Maze and olfactory discrimination learning task. At 6 months, DBA/2J and D2.mpc1b mice outperformed C57BL/6J and B6.mpc1d mice in the visual detection task and there were no strain differences in performance on the water maze. At 12, 18 and 24 months, C57BL/6J and B6.mpc1d mice outperformed DBA/2J and D2.mpc1b mice in the vision tasks and in the water maze. Strains did not differ in the olfactory learning task. Therefore, loss of visual function occurs between 6 and 12 months of age in DBA/2J mice. Strain differences in visual task performance accounted for a significant proportion of the variance in measures of learning and memory in the water maze at 12, 18 and 24 months of age.