South African Medical Journal

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Cortical lens opacities in the young patient- an indication for a lipogram?

D Meyer, FJ Maritz, PH Liebenberg, DP Parkin, LJ Burgess


Aim. To determine the characteristics and prevalence of lenticular opacification in patients with underlying dyslipidaemia.

Methods. Eighty patients of both genders and all ages (18- 90 years) were enrolled in the trial if they met the inclusion criteria for dyslipidaernia: 

Patients were included if their fasting serum cholesterol and triglyceride concentrations were > 5.2 mmol/l and > 2.3 mmol/l, respectively, when measured on three separate occasions over a 1-month period. 

Patients were excluded if they suffered from any condition known to cause or predispose them to elevated lipid levels or lenticular opacification. Lenticular changes were assessed by means of a slit-lamp through the fully dilated pupil and other physical signs were documented subsequent to thorough physical evaluation.

Results. In addition to the classic clinic signs of dyslipidaemia, 31% of patients had cortical lens opacities. Cortical opacities were twice as prevalent as Achilles tendon thickening (16.3%) in our study, the second most prevalent sign of elevated lipid levels. In the subgroup of patients aged under 50 years, 55% had lenticular opacities, predominantly cortical (80%).

Conclusions. Cortical lens opacification was the most prevalent sign of dyslipidaemia and it occurred at a relatively young age in our trial population in those patients who were affected. Cortical lenticular opacification should be regarded as an indication for blood lipid profile evaluation.

AJOL African Journals Online