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Mansour AM. Progressive symmetric vertical macular wide angioid streak-like lacquer crack. Int Med Case Rep J. 2016;9:95-9doi: 10.2147/IMCRJ.S103068.
Mansour, A. M. (2016). Progressive symmetric vertical macular wide angioid streak-like lacquer crack. International medical case reports journal, 995-9. https://doi.org/10.2147/IMCRJ.S103068
Mansour, Ahmad M. "Progressive symmetric vertical macular wide angioid streak-like lacquer crack." International medical case reports journal vol. 9 (2016): 95-9. doi: https://doi.org/10.2147/IMCRJ.S103068
Mansour AM. Progressive symmetric vertical macular wide angioid streak-like lacquer crack. Int Med Case Rep J. 2016 Apr 19;9:95-9. doi: 10.2147/IMCRJ.S103068. eCollection 2016. PMID: 27186081; PMCID: PMC4847605.
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Int Med Case Rep J. 2016 Apr 19;9:95-9. doi: 10.2147/IMCRJ.S103068. eCollection 2016.

Progressive symmetric vertical macular wide angioid streak-like lacquer crack.

International medical case reports journal

Ahmad M Mansour

Affiliations

  1. Department of Ophthalmology, American University of Beirut, Lebanon; Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon.

PMID: 27186081 PMCID: PMC4847605 DOI: 10.2147/IMCRJ.S103068

Abstract

PURPOSE: We report an unusual case of bilateral vertical lacquer crack with no history of ocular trauma and with progressive marked enlargement and consequent visual loss.

METHODS: Three-year follow-up was completed using best-corrected visual acuity, serial fundus photographs, intravenous fluorescein angiography, and optical coherence tomography.

RESULTS: We report the occurrence of lacquer crack in a 43-year-old woman with no history of trauma except for laser in situ keratomileusis surgery for mild myopia (as reported by the patient) in the past 5 years and habitual ocular rubbing. Lacquer crack started in the right eye and became evident 1 year later in the left eye. Serial photography after repeated intravitreal injections of ranibizumab for subfoveal choroidal new vessel showed the lacquer crack widened gradually in both eyes. Axial length measurement revealed the presence of high myopia. Best-corrected visual acuity dropped to 20/200 bilaterally.

CONCLUSION: We hypothesize that a thin Bruch's membrane in high myopia is prone for small rupture initially either spontaneously or following laser in situ keratomileusis and subsequent widening of the rupture by oculopression and intravitreal injections from rise in intraocular pressure.

Keywords: Bruch’s membrane rupture; LASIK; angioid streak; choroidal neovascularization; choroidal rupture; high myopia; lacquer crack

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