A cross-sectional study of Krukenberg spindles and pigmented lens striae in a predominately black population: two highly associated clinical signs of anterior segment pigment dispersal.
OBJECTIVE
To investigate the relationship of Krukenberg spindles (KS) and pigmented lens striae (PLS), clinical signs related to iris pigment dispersal and possibly glaucoma.


METHODS
During a 31-month period, 5 practitioners in an urban, primary eye care setting examined consecutive patients for KS and PLS. Multiple logistic regression was used to evaluate relationships among KS, PLS, and other variables.


RESULTS
Krukenberg spindles were present in 65 patients (52 females), comprised of 57 of 2647 (2.2%) blacks, 5 of 303 (1.7%) whites, 2 of 121 (1.7%) Hispanics, and 1 of 55 (1.8%) Asians. PLS were present in 64 subjects (56 females), comprised of 59 (2.2%) blacks, 3 (1.0%) whites, and 2 (3.6%) Asians. KS and PLS were coexistent in 27 subjects. Mean age +/- SD (range) of the KS and PLS subjects was 63.1 +/- 15.0 years (24-88 years) and 67.0 +/- 10.4 years (33-88 years), respectively. Mean refractive error +/- SD (range) of KS and PLS right eyes was +0.55 +/- 2.32D (-6.50 to +5.50D) and +1.34 +/- 2.18D (-6.50 to +7.25D), respectively. Controlling for other variables, PLS were highly predictive (OR = 30.2, P < 0.0001) of KS, and KS were highly predictive (OR = 29.5, P < 0.0001) of PLS. Ignoring presence or absence of PLS, increasing age (in decades) (OR = 1.60, P < 0.0001) was strongly associated with KS. Ignoring presence or absence of KS, age (OR = 1.74, P < 0.0001), female gender (OR = 2.96, P = 0.009), and increasing hyperopic refractive error (OR = 1.30, P < 0.0001) were strongly associated with PLS.


CONCLUSIONS
Krukenberg spindles and PLS were strongly associated in our patient population, and the likelihood of both increased with increasing age. Female gender and increasing hyperopic refractive error were highly significant predictors of PLS.
Roberts
Daniel K
DK
Illinois Eye Institute, Illinois College of Optometry, Chicago, Illinois 60616, USA. droberts@eyecare.ico.edu
Winters
Janis Ecklund
JE
Castells
David D
DD
Teitelbaum
Bruce A
BA
Alexander
Cathy Clark
CC
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000473:pathology*; D044383:Black People; D003430:Cross-Sectional Studies; D017889:Exfoliation Syndrome / Q000175:diagnosis / Q000208:ethnology*; D005260:Female; D005901:Glaucoma / Q000175:diagnosis / Q000208:ethnology*; D006801:Humans; D007498:Iris / Q000473:pathology; D007903:Lens Capsule, Crystalline / Q000473:pathology; D007905:Lens Diseases / Q000175:diagnosis / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution