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CLINICAL FEATURES OF LACQUER CRACKS IN EYES WITH PATHOLOGIC MYOPIA

Xu, Xian, MD*,†; Fang, Yuxin, MD*; Uramoto, Kengo, MD*; Nagaoka, Natsuko, MD*; Shinohara, Kosei, MD*; Yokoi, Tae, MD*; Tanaka, Noriko, MD*; Ohno-Matsui, Kyoko, MD, PhD*

doi: 10.1097/IAE.0000000000002168
Original Study: PDF Only

Purpose: To analyze the morphologic features of lacquer cracks (LCs), compare their detectability by different imaging instruments, and determine their progressive pattern.

Methods: The medical records of 47 highly myopic eyes of 33 patients with LCs were reviewed. Fundus fluorescein angiography was used as the primary method of identifying LCs, and the detection rate was compared with that by fundus autofluorescence and optical coherence tomography.

Results: A total of 176 LCs were detected in the 47 eyes. Lacquer cracks were detected more frequently in the temporal (44.3%) than the inferior (30.7%), superior (17.0%), and nasal (8.0%) quadrants of the retina. The detection rate of LCs was 98% in fundus photographs and 85% by fundus autofluorescence and optical coherence tomography. A progression of the LCs was observed in 22 of the 41 eyes with a follow-up period of ≥1 year. The progression patterns were an increase in the number (18 of 41, including 5 eyes in which new LCs had a branching pattern), elongation (4 of 41), and progression to patchy atrophy (6 of 41).

Conclusion: Lacquer cracks can be detected noninvasively by fundus autofluorescence and optical coherence tomography; however, improvements are necessary to detect all of the lesions. Lacquer cracks frequently progress with time, and an increase in the number of LCs was the most frequent progression pattern.

This was a retrospective and consecutive case series study of lacquer cracks in eyes with pathologic myopia. Lacquer cracks can be detected by noninvasive fundus autofluorescence and optical coherence tomography; however, improvements are necessary to detect all the lacquer cracks. An increase in the number of lacquer cracks was the most frequent progression pattern.

*Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan; and

Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China.

Reprint requests: Kyoko Ohno-Matsui, MD, PhD, Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University; 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; e-mail: k.ohno.oph@tmd.ac.jp

Supported by grants from the Japanese Society for Promotion of Science (Number; 15H04993, 15K15629). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

None of the authors has any financial/conflicting interests to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.retinajournal.com).

© 2018 by Ophthalmic Communications Society, Inc.