WordNet

electronic equipment that uses a magnetic or electric field in order to focus a beam of electrons (同)electron lens
a transparent optical device used to converge or diverge transmitted light and to form images (同)lense, lens system
biconvex transparent body situated behind the iris in the eye; its role (along with the cornea) is to focuses light on the retina (同)crystalline_lens, lens of the eye
(metaphor) a channel through which something can be seen or understood; "the writer is the lens through which history can be seen"
genus of small erect or climbing herbs with pinnate leaves and small inconspicuous white flowers and small flattened pods: lentils (同)genus Lens
partial displacement of a joint or organ

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『レンズ』 / (目の)水晶体

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/10/05 11:13:11」(JST)

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Anterior lens luxation in a dog

Anterior lens luxation with cataract formation in a cat

Ectopia lentis is a displacement or malposition of the eye's crystalline lens from its normal location. A partial dislocation of a lens is termed lens subluxation or subluxated lens; a complete dislocation of a lens is termed lens luxation or luxated lens.

Ectopia lentis in dogs and cats[edit]

Although observed in humans and cats, ectopia lentis is most commonly seen in dogs. Ciliary zonules normally hold the lens in place. Abnormal development of these zonules can lead to primary ectopia lentis, usually a bilateral condition. Luxation can also be a secondary condition, caused by trauma, cataract formation (decrease in lens diameter may stretch and break the zonules), or glaucoma (enlargement of the globe stretches the zonules). Steroid administration weakens the zonules and can lead to luxation as well. Lens luxation in cats can occur secondary to anterior uveitis (inflammation of the inside of the eye).

Anterior lens luxation[edit]

With anterior lens luxation, the lens pushes into the iris or actually enters the anterior chamber of the eye. This can cause glaucoma, uveitis, or damage to the cornea. Uveitis (inflammation of the eye) causes the pupil to constrict (miosis) and trap the lens in the anterior chamber, leading to an obstruction of outflow of aqueous humour and subsequent increase in ocular pressure (glaucoma).^[1] Surgery to remove the lens has a higher success rate (retained vision and normal intraocular pressure) when it is performed before the onset of secondary glaucoma.^[2] Glaucoma secondary to anterior lens luxation is less common in cats than dogs due to their naturally deeper anterior chamber and the liquification of the vitreous humour secondary to chronic inflammation.^[3] Anterior lens luxation is considered to be an ophthalmological emergency.

Posterior lens luxation[edit]

With posterior lens luxation, the lens falls back into the vitreous humour and lies on the floor of the eye. This type causes fewer problems than anterior lens luxation, although glaucoma or ocular inflammation may occur. Surgery is used to treat dogs with significant symptoms. Removal of the lens before it moves to the anterior chamber may prevent secondary glaucoma.^[2]

Lens subluxation[edit]

Lens subluxation is also seen in dogs and is characterized by a partial displacement of the lens. It can be recognized by trembling of the iris (iridodonesis) or lens (phacodonesis) and the presence of an aphakic crescent (an area of the pupil where the lens is absent).^[4] Other signs of lens subluxation include mild conjunctival redness, vitreous humour degeneration, prolapse of the vitreous into the anterior chamber, and an increase or decrease of anterior chamber depth.^[5] Removal of the lens before it completely luxates into the anterior chamber may prevent secondary glaucoma.^[2] A nonsurgical alternative involves the use of a miotic to constrict the pupil and prevent the lens from luxating into the anterior chamber.^[6]

Breed predisposition[edit]

Terrier breeds are predisposed to lens luxation, and it is probably inherited in the Sealyham Terrier, Jack Russell Terrier, Wirehaired Fox Terrier, Rat Terrier, Teddy Roosevelt Terrier, Tibetan Terrier,^[7] Miniature Bull Terrier, Shar Pei, and Border Collie.^[8] The mode of inheritance in the Tibetan Terrier^[5] and Shar Pei^[9] is likely autosomal recessive. Labrador Retrievers and Australian Cattle Dogs are also predisposed.^[10]

Systemic associations in humans[edit]

In humans, there are a number of systemic conditions that are associated with ectopia lentis:^[11]

More common:

Marfan syndrome (upward and outward)^[12]
Homocystinuria (downward and inwards)^[12]
Weill-Marchesani syndrome
Sulfite oxidase deficiency
Hyperlysinemia

Less common:

Ehlers-Danlos syndrome
Crouzon disease
Refsum syndrome
Kniest syndrome
Mandibulofacial dysostosis
Sturge-Weber syndrome
Conradi syndrome
Pfaundler syndrome
Pierre Robin syndrome
Wildervanck syndrome
Sprengel deformity

References[edit]

^ Ketring, Kerry I. (2006). "Emergency Treatment for Anterior Lens Luxation" (PDF). Proceedings of the North American Veterinary Conference. Retrieved 2007-02-22.
^ ^a ^b ^c Glover T, Davidson M, Nasisse M, Olivero D (1995). "The intracapsular extraction of displaced lenses in dogs: a retrospective study of 57 cases (1984-1990)". Journal of the American Animal Hospital Association 31 (1): 77–81. PMID 7820769.
^ Peiffer, Robert L., Jr. (2004). "Diseases of the Lens in Dogs and Cats". Proceedings of the 29th World Congress of the World Small Animal Veterinary Association. Retrieved 2007-02-22.
^ "Lens". The Merck Veterinary Manual. 2006. Retrieved 2007-02-22.
^ ^a ^b Grahn B, Storey E, Cullen C (2003). "Diagnostic ophthalmology. Congenital lens luxation and secondary glaucoma". Canadian Veterinary Journal 44 (5): 427, 429–30. PMC 340155. PMID 12757137.
^ Binder DR, Herring IP, Gerhard T (2007). "Outcomes of nonsurgical management and efficacy of demecarium bromide treatment for primary lens instability in dogs: 34 cases (1990-2004)". Journal of the American Veterinary Medical Association 231 (1): 89–93. doi:10.2460/javma.231.1.89. PMID 17605669.
^ Gelatt, Kirk N. (ed.) (1999). Veterinary Ophthalmology (3rd ed.). Lippincott, Williams & Wilkins. ISBN 0-683-30076-8.
^ Petersen-Jones, Simon M. (2003). "Conditions of the Lens". Proceedings of the 28th World Congress of the World Small Animal Veterinary Association. Retrieved 2007-02-22.
^ Lazarus J, Pickett J, Champagne E (1998). "Primary lens luxation in the Chinese Shar Pei: clinical and hereditary characteristics". Veterinary Ophthalmology 1 (2-3): 101–107. doi:10.1046/j.1463-5224.1998.00021.x. PMID 11397217.
^ Johnsen D, Maggs D, Kass P (2006). "Evaluation of risk factors for development of secondary glaucoma in dogs: 156 cases (1999-2004)". Journal of the American Veterinary Medical Association 229 (8): 1270–4. doi:10.2460/javma.229.8.1270. PMID 17042730.
^ Eifrig CW, Eifrig DE. "Ectopia Lentis". eMedicine.com. November 24, 2004.
^ ^a ^b Peter Nicholas Robinson; Maurice Godfrey (2004). Marfan syndrome: a primer for clinicians and scientists. Springer. pp. 5–. ISBN 978-0-306-48238-0. Retrieved 12 April 2010.

External links[edit]

GeneReviews/NCBI/NIH/UW entry on ADAMTSL4-Related Eye Disorders,Autosomal Recessive Isolated Ectopia Lentis,Ectopia Lentis et Pupillae

UpToDate Contents

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1. 小児における水晶体偏位（水晶体脱臼） ectopia lentis dislocated lens in children
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English Journal

Anterior haptic flexing and in-the-bag subluxation of an accommodating intraocular lens due to excessive capsular bag contraction.

Kramer GD1, Werner L2, Neuhann T1, Tetz M1, Mamalis N1.
Journal of cataract and refractive surgery.J Cataract Refract Surg.2015 Oct 12. pii: S0886-3350(15)00998-0. doi: 10.1016/j.jcrs.2015.08.009. [Epub ahead of print]
We describe the case of a patient who had cataract surgery with implantation of the hydrophilic acrylic Tetraflex accommodating intraocular lens (IOL), with subsequent development of capsulorhexis phimosis and in-the-bag IOL subluxation. Contraction of the capsular bag secondary to fibrosis resulted
PMID 26471049

[Exfoliative zonulopathy leading to an inferior subluxation of the "caspular bag, caspular tension ring and intraocular lens" complex].

Govare M1, Schweitzer C2, Delyfer MN2, Korobelnik JF2.
Journal français d'ophtalmologie.J Fr Ophtalmol.2015 Oct;38(8):782. doi: 10.1016/j.jfo.2014.11.023. Epub 2015 Jul 18.
PMID 26194554

A RANDOMIZED, PLACEBO-CONTROLLED STUDY OF INTRAVITREAL OCRIPLASMIN IN PEDIATRIC PATIENTS SCHEDULED FOR VITRECTOMY.

Drenser K1, Girach A, Capone A Jr.
Retina (Philadelphia, Pa.).Retina.2015 Sep 21. [Epub ahead of print]
PURPOSE: To evaluate safety and preliminary efficacy of 175 μg of intravitreal ocriplasmin in pediatric patients scheduled for vitrectomy.METHODS: Based on a single-center, prospective, randomized, placebo-controlled, and double-masked Phase 2 study, 22 pediatric patients scheduled for vitrectomy w
PMID 26398685

Japanese Journal

水晶体亜脱臼と多発性後極部網膜色素上皮症(MPPE)を合併した緑内障の1例

善本三和子,桃原久枝,松元俊
あたらしい眼科 = Journal of the eye 30(4), 561-567, 2013-04-30
NAID 10031168124

水晶体亜脱臼と多発性後極部網膜色素上皮症(MPPE)を合併した緑内障の1例

善本三和子,桃原久枝,松元俊
あたらしい眼科 30(4), 561-567, 2013-04
NAID 40019675239

外傷性散瞳を伴う水晶体亜脱臼に対し, 虹彩付き眼内レンズを縫着した1例

山下和哉,鳥居秀成,根岸一乃,渡辺一弘,重野雄太,佐伯めぐみ,坪田一男
IOL & RS : Japanese journal of cataract and refractive surgery : 日本眼内レンズ屈折手術学会誌 26(4), 448-452, 2012-12-28
NAID 10031144393