Lacquer Cracks and Perforating Scleral Vessels in Pathologic Myopia

A Possible Causal Relationship

Giuseppe Querques, Federico Corvi, Chandrakumar Balaratnasingam, Giuseppe Casalino, Maurizio Battaglia Parodi, Ugo Introini, K. Bailey Freund, Francesco Bandello

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose To describe a possible causal association between the position of perforating scleral vessels and the position of lacquer cracks in eyes with pathologic myopia. Design Retrospective case series. Methods Medical records and multimodal imaging results, including confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography, were reviewed from patients with lacquer cracks secondary to pathologic myopia who presented between 2010 and 2014 to 2 institutions. Main outcome measures were the prevalence of perforating scleral vessels at the site of the lacquer crack, the position of the lacquer crack within the macula, and the relationships between perforating scleral vessels and retinal-choroidal structures. Results A total of 35 eyes of 30 patients with lacquer cracks were included. The average number of lacquer cracks was 1.2 ± 0.5/eye and in 37 out of 45 lacquer cracks (82%) retrobulbar vessels were found to perforate the sclera at the site of the lacquer crack. Lacquer cracks were more prevalent in the central macula (51%) than in the nasal (19%), temporal (14%), inferior (11%), and superior macula (5%) (P =.001). Transverse en face images through the area of lacquer cracks were available for 8 cases and clearly depicted the perforating vessel's course through the sclera and its termination in the choroid, directly beneath the lacquer cracks. Conclusions Perforating scleral vessels are often present beneath the site at which lacquer cracks form in pathologic myopia. We hypothesize that scleral expansion at the location of these perforating vessels may play a role in the formation of lacquer cracks.

Original languageEnglish
Pages (from-to)759-766e2
JournalAmerican Journal of Ophthalmology
Volume160
Issue number4
DOIs
Publication statusPublished - Oct 1 2015

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Lacquer
Myopia
Sclera
Multimodal Imaging
Ophthalmoscopy
Retinal Vessels
Choroid
Optical Coherence Tomography
Diagnostic Imaging
Nose

ASJC Scopus subject areas

  • Ophthalmology
  • Medicine(all)

Cite this

Lacquer Cracks and Perforating Scleral Vessels in Pathologic Myopia : A Possible Causal Relationship. / Querques, Giuseppe; Corvi, Federico; Balaratnasingam, Chandrakumar; Casalino, Giuseppe; Parodi, Maurizio Battaglia; Introini, Ugo; Freund, K. Bailey; Bandello, Francesco.

In: American Journal of Ophthalmology, Vol. 160, No. 4, 01.10.2015, p. 759-766e2.

Research output: Contribution to journalArticle

Querques, Giuseppe ; Corvi, Federico ; Balaratnasingam, Chandrakumar ; Casalino, Giuseppe ; Parodi, Maurizio Battaglia ; Introini, Ugo ; Freund, K. Bailey ; Bandello, Francesco. / Lacquer Cracks and Perforating Scleral Vessels in Pathologic Myopia : A Possible Causal Relationship. In: American Journal of Ophthalmology. 2015 ; Vol. 160, No. 4. pp. 759-766e2.
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abstract = "Purpose To describe a possible causal association between the position of perforating scleral vessels and the position of lacquer cracks in eyes with pathologic myopia. Design Retrospective case series. Methods Medical records and multimodal imaging results, including confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography, were reviewed from patients with lacquer cracks secondary to pathologic myopia who presented between 2010 and 2014 to 2 institutions. Main outcome measures were the prevalence of perforating scleral vessels at the site of the lacquer crack, the position of the lacquer crack within the macula, and the relationships between perforating scleral vessels and retinal-choroidal structures. Results A total of 35 eyes of 30 patients with lacquer cracks were included. The average number of lacquer cracks was 1.2 ± 0.5/eye and in 37 out of 45 lacquer cracks (82{\%}) retrobulbar vessels were found to perforate the sclera at the site of the lacquer crack. Lacquer cracks were more prevalent in the central macula (51{\%}) than in the nasal (19{\%}), temporal (14{\%}), inferior (11{\%}), and superior macula (5{\%}) (P =.001). Transverse en face images through the area of lacquer cracks were available for 8 cases and clearly depicted the perforating vessel's course through the sclera and its termination in the choroid, directly beneath the lacquer cracks. Conclusions Perforating scleral vessels are often present beneath the site at which lacquer cracks form in pathologic myopia. We hypothesize that scleral expansion at the location of these perforating vessels may play a role in the formation of lacquer cracks.",
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AU - Querques, Giuseppe

AU - Corvi, Federico

AU - Balaratnasingam, Chandrakumar

AU - Casalino, Giuseppe

AU - Parodi, Maurizio Battaglia

AU - Introini, Ugo

AU - Freund, K. Bailey

AU - Bandello, Francesco

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N2 - Purpose To describe a possible causal association between the position of perforating scleral vessels and the position of lacquer cracks in eyes with pathologic myopia. Design Retrospective case series. Methods Medical records and multimodal imaging results, including confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography, were reviewed from patients with lacquer cracks secondary to pathologic myopia who presented between 2010 and 2014 to 2 institutions. Main outcome measures were the prevalence of perforating scleral vessels at the site of the lacquer crack, the position of the lacquer crack within the macula, and the relationships between perforating scleral vessels and retinal-choroidal structures. Results A total of 35 eyes of 30 patients with lacquer cracks were included. The average number of lacquer cracks was 1.2 ± 0.5/eye and in 37 out of 45 lacquer cracks (82%) retrobulbar vessels were found to perforate the sclera at the site of the lacquer crack. Lacquer cracks were more prevalent in the central macula (51%) than in the nasal (19%), temporal (14%), inferior (11%), and superior macula (5%) (P =.001). Transverse en face images through the area of lacquer cracks were available for 8 cases and clearly depicted the perforating vessel's course through the sclera and its termination in the choroid, directly beneath the lacquer cracks. Conclusions Perforating scleral vessels are often present beneath the site at which lacquer cracks form in pathologic myopia. We hypothesize that scleral expansion at the location of these perforating vessels may play a role in the formation of lacquer cracks.

AB - Purpose To describe a possible causal association between the position of perforating scleral vessels and the position of lacquer cracks in eyes with pathologic myopia. Design Retrospective case series. Methods Medical records and multimodal imaging results, including confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography, were reviewed from patients with lacquer cracks secondary to pathologic myopia who presented between 2010 and 2014 to 2 institutions. Main outcome measures were the prevalence of perforating scleral vessels at the site of the lacquer crack, the position of the lacquer crack within the macula, and the relationships between perforating scleral vessels and retinal-choroidal structures. Results A total of 35 eyes of 30 patients with lacquer cracks were included. The average number of lacquer cracks was 1.2 ± 0.5/eye and in 37 out of 45 lacquer cracks (82%) retrobulbar vessels were found to perforate the sclera at the site of the lacquer crack. Lacquer cracks were more prevalent in the central macula (51%) than in the nasal (19%), temporal (14%), inferior (11%), and superior macula (5%) (P =.001). Transverse en face images through the area of lacquer cracks were available for 8 cases and clearly depicted the perforating vessel's course through the sclera and its termination in the choroid, directly beneath the lacquer cracks. Conclusions Perforating scleral vessels are often present beneath the site at which lacquer cracks form in pathologic myopia. We hypothesize that scleral expansion at the location of these perforating vessels may play a role in the formation of lacquer cracks.

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