A case of dense pigment deposition of the posterior lens capsule

Abstract

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.

Annular pigment ring on the posterior lens capsule: a novel examination finding in blunt ocular trauma

“…Pigmentation of the posterior lens also has been reported in pigment dispersion syndrome. 4,5 We do not feel that this was a likely cause in our patient given the absence of other characteristic features in pigment dispersion syndrome.…”

Posterior Capsular Pigment Deposition: A Rare Presentation of Pigment Dispersion Syndrome

“…There have been reports of unilateral and bilateral pigment deposition on the posterior lens capsule without a history of trauma. [5][6][7][8][9][10][11] In the classic presentation of PDS, pigmentation of the lens capsule is seen in the periphery of the lens, known as Scheie's or Zentmayer's line. 2,4 To detect more central posterior capsular pigmentation there must be an anatomical anomaly or a defect in the ligament of Wieger to allow aqueous flow from the posterior chamber to the retrolental space.…”