Accommodation Measured with Optical Coherence Tomography in Patients with Marfan's Syndrome

Purpose: To evaluate accommodation in patients with Marfan's syndrome using optical coherence tomography (OCT). Design: Clinical case-control study. Participants and Controls: The study included 31 eyes of 31 patients with Marfan's syndrome and 31 eyes of 31 unaffected controls. Subgroups of eyes of patients with Marfan's syndrome with and without a subluxated lens also were compared. Methods: The changes in the anterior segment during accommodation and cycloplegia were studied with OCT. Main Outcome Measures: Accommodative power, anterior chamber depth (ACD), lens thickness, and pupil diameter. Results: No difference in accommodative power or ACD were found between the groups (P>0.05). The lens was thicker in the presence of Marfan's syndrome (P = 0.017 at baseline; P = 0.043 during accommodation; P = 0.046 during dilatation). The baseline pupil diameter was smaller in patients with Marfan's syndrome (P = 0.01), decreased less during accommodation (P = 0.02), and increased more during dilatation compared with controls (P<0.01). No difference was found in these variables between the subgroups of eyes of patients with Marfan's syndrome with and without a subluxated lens (P>0.05). Conclusions: The results of this study suggested that even though the pupil and crystalline lens are affected in patients with Marfan's syndrome, these patients have the same ability to accommodate as normal subjects. Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article. Ophthalmology 2009,-116.-1343-1348 (C) 2009 by the American Academy of Ophthalmology.