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Decreasing myopic lacquer crack and widening parapapillary gamma zone: case report

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机构: [1]Univ Hosp Cologne, Dept Ophthalmol, Cologne, Germany [2]Capital Univ Med Sci, Beijing Tongren Hosp, Beijing Ophthalmol & Visual Sci Key Lab, Beijing Tongren Eye Ctr,Beijing Inst Ophthalmol, 1 Dongjiaomin Lane, Beijing 100730, Peoples R China [3]Heidelberg Univ, Med Fac Mannheim, Dept Ophthalmol, Kutzerufer 1, D-68167 Mannheim, Germany [4]Inst Mol & Clin Ophthalmol Basel, Basel, Switzerland [5]Privatpraxis Prof Jonas & Dr Panda Jonas, Heidelberg, Germany
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关键词: Lacquer crack Gamma zone Myopia maculopathy Pathologic myopia Case report High myopia Parapapillary gamma zone Parapapillary delta zone

摘要:
Background Myopic axial elongation may be due to an equatorial enlargement of Bruch's membrane (BM), leading to a prolate eye shape and increasing strain with BM and the retinal pigment epithelium (RPE) layer at the posterior pole. The increased BM strain may cause an enlargement of Bruch's membrane opening (BMO) of the optic nerve head, with the subsequent development and enlargement of parapapillary gamma zone as BM-free parapapillary zone. The increased strain within BM and RPE may also cause lacquer cracks (LCs) as linear breaks in the RPE and / or BM. Studies suggested that a more marked gamma zone enlargement is associated with lower prevalence of LCs or macular BM defects. Here report on the disappearance of a LC during a 10-year follow-up of a highly myopic eye, concurrent with a marked increase in gamma zone. Case presentation A 56-year-old woman showed in her right eye (axial length measured 30.69 mm) a LC, vertically oval optic disc, and parapapillary gamma zone in 2001. When re-examined in 2006, gamma zone had enlarged, while the LC was no longer detectable. In 2011, the LC was not visible neither upon ophthalmoscopy and or upon optical coherence tomography (OCT), while gamma zone had further enlarged. The gamma zone enlargement occurred in a direction perpendicular to the direction of the former LC. Conclusions The observation suggest that a LC can decrease in width, in temporal association with an enlargement of gamma zone. It fits with the notion that an enlargement of the BMO (i.e., enlarging gamma zone) may lead to a relaxation of the BM strain and subsequently to a decrease in the width of the LC.

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出版当年[2020]版:
大类 | 4 区 医学
小类 | 4 区 眼科学
最新[2023]版:
大类 | 4 区 医学
小类 | 3 区 眼科学
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出版当年[2019]版:
Q3 OPHTHALMOLOGY
最新[2023]版:
Q3 OPHTHALMOLOGY

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第一作者机构: [1]Univ Hosp Cologne, Dept Ophthalmol, Cologne, Germany
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通讯机构: [3]Heidelberg Univ, Med Fac Mannheim, Dept Ophthalmol, Kutzerufer 1, D-68167 Mannheim, Germany [4]Inst Mol & Clin Ophthalmol Basel, Basel, Switzerland [5]Privatpraxis Prof Jonas & Dr Panda Jonas, Heidelberg, Germany
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