Lacquer Cracks and Perforating Scleral Vessels in Pathologic Myopia: A Possible Causal Relationship

Area of Science:

• Ophthalmology
• Pathologic Myopia Research
• Vascular Anatomy

Background:

• Pathologic myopia is associated with lacquer crack formation.
• The exact etiology of lacquer cracks remains incompletely understood.
• Understanding lacquer crack development is crucial for managing myopia-related complications.

Observation:

• A retrospective case series analyzed 35 eyes with lacquer cracks in pathologic myopia.
• Multimodal imaging, including confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography, was utilized.
• The study focused on the relationship between perforating scleral vessels and lacquer crack locations.

Findings:

• Perforating scleral vessels were identified at the site of lacquer cracks in 82% of cases.
• Lacquer cracks were most prevalent in the central macula (51%).
• En face imaging confirmed perforating vessels coursing through the sclera to the choroid beneath lacquer cracks.

Implications:

• Perforating scleral vessels may play a significant role in the pathogenesis of lacquer cracks.
• Scleral expansion at perforating vessel sites is hypothesized to contribute to lacquer crack formation.
• Further research could explore therapeutic strategies targeting these vascular anomalies in pathologic myopia.