title: Pigmented striae of the anterior lens capsule and age-associated pigment dispersion of variable degree in a group of older African-Americans: an age, race, and gender matched study.
abstract: OBJECTIVE
  To investigate pigmented striae of the anterior lens capsule in African-Americans, a potential indicator of significant anterior segment pigment dispersion.
  
  
  METHODS
  A group of 40 African-American subjects who exhibited pigmented lens striae (PLS) were identified from a non-referred, primary eye care population in Chicago, IL, USA. These subjects were then compared to an age, race, and gender matched control group relative to refractive error and the presence or absence of diabetes and hypertension.
  
  
  RESULTS
  The PLS subjects (mean age = 65.4 +/- 8.8 years, range = 50-87 years) consisted of 36 females and 4 males. PLS were bilateral in 36 (85%) of the 40 subjects. Among the eyes with PLS, 21 (55%) of 38 right eyes and 22 (61%) of 36 left eyes also had significant corneal endothelial pigment dusting, commonly in the shape of a Krukenberg's spindle. Ten (25%) of the PLS subjects had either glaucoma or ocular hypertension (7 bilateral, 3 unilateral). The presence of trabecular meshwork pigment varied from minimal to heavy. The mean +/- SD (range) refractive error of the PLS right eyes was +1.61 +/- 1.43D (-1.50 to +5.00D) and +1.77 +/- 1.37D (-1.00 to +5.00D) for the left eyes. Based on these data, the PLS right eyes were +1.63D (Student's t, p = 0.0001; 95% CI = +0.82 to +2.44D) more hyperopic on average than the control right eyes, and the PLS left eyes were +1.77D (p = 0.0001; 95% CI = +0.92 to +2.63D) more hyperopic on average than the control left eyes. Trend analysis showed a gradually increasing likelihood of PLS with increasing magnitude of hyperopia in both eyes (Mantel-Haenszel chi-square, p = 0.001). Among PLS subjects, 24 (60%) of 40 were hypertensive and 9 (23%) of 40 were diabetic. However, these proportions were not significantly different (two-tailed Fisher's exact test; hypertension: p = 0.30; diabetes: p = 0.70) from the randomly selected controls.
  
  
  CONCLUSIONS
  Among our African-American group, which consisted predominately of females >50 years of age, the likelihood of PLS increased with increasing hyperopic refractive error. This finding is consistent with the possibility that PLS may, in some circumstances, indicate a significant pigment dispersal process due to iris-lens rubbing that may be associated with crowding of anterior segment structures. Additional study is warranted to further assess the nature of PLS, their precise relationship with an age-related pigment dispersal process, and their true significance as a risk factor for development of glaucoma.
authors.affiliation: Illinois Eye Institute, Illinois College of Optometry, Chicago, IL 60616, USA. droberts@eyecare.ico.edu
authors.forename: D K
authors.initials: DK
authors.lastname: Roberts
authors.forename: J E
authors.initials: JE
authors.lastname: Winters
authors.forename: D D
authors.initials: DD
authors.lastname: Castells
authors.forename: C A
authors.initials: CA
authors.lastname: Clark
authors.forename: B A
authors.initials: BA
authors.lastname: Teitelbaum
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology*; D006973:Hypertension / Q000503:physiopathology; D007903:Lens Capsule, Crystalline / Q000378:metabolism / Q000503:physiopathology*; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D010858:Pigmentation; D010860:Pigments, Biological / Q000378:metabolism*; D012727:Sex Characteristics
chemical_list: D010860:Pigments, Biological