Extended-depth spectral-domain optical coherence tomography imaging of the crystalline lens in Weill-Marchesani-like syndrome

A 26-year-old woman presented with signs and symptoms of acute angle-closure glaucoma (ACG) in her left eye. Extended-depth spectral-domain optical coherence tomography (SD-OCT) was performed to biometrically assess the anterior chamber depth and crystalline lens conformation. Extended-depth SD-OCT imaging of the crystalline lens showed bilateral spherophakia without dislocation. Neither eye manifested a highly myopic refractive error despite spherophakia. Unanticipated conformation of the anterior and posterior lenticular curvatures, increased thickness of the crystalline lenses, and short axial lengths explained the lack of a highly myopic refractive error. These findings demonstrated a lens-related cause of the ACG. The use of extended-depth SD-OCT supported the diagnosis of subclinical Weill-Marchesani syndrome in a patient without other commonly associated findings and provided a better understanding of the mechanism of angle closure in this patient.