Lacquer Cracks and Perforating Sclera Vessels in Pathologic Myopia: A Possible Causal Relationship
Lacquer Cracks and Perforating Sclera Vessels in Pathologic Myopia: A Possible Causal Relationship
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DOI：
10.1016/j.ajo.2015.07.017
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发表时间：
2015-10-01
影响因子：
4.2
通讯作者：
Bandello, Francesco
中科院分区：
文献类型：
--
作者：
Querques, Giuseppe;Corvi, Federico;Bandello, Francesco
目得：描述病理性近视眼中巩膜穿通血管的位置和漆样裂纹的位置之间可能的因果关系。设计：回顾性病例系列。方法：医疗记录和多模式成像结果，包括共焦扫描激光检眼镜和光谱域光学相干断层扫描，对2010年至2014年间在2家机构就诊的继发于病理性近视的漆样裂纹患者进行了审查。主要观察指标为漆裂处巩膜穿通血管的发生率、漆裂在黄斑内的位置以及巩膜穿通血管与视网膜脉络膜结构的关系。漆裂纹的平均数量为1.2 +/- 0.5/眼，在45个漆裂纹中的37个（82%）中，发现球后血管覆盖漆裂纹部位的巩膜。漆裂纹在中央黄斑（51%）比鼻（19%）、颞（14%）、下（11%）和上级黄斑（5%）更普遍（P= 0.001）。通过该地区的漆裂纹的横向正面图像可为8例，并清楚地描绘了穿血管的过程中，通过巩膜和其终止脉络膜，直接下方的漆cracks.Conclusions：穿巩膜血管往往存在于漆裂纹形成的病理性近视的网站之下。我们推测这些穿通血管位置处的巩膜扩张可能在漆裂纹的形成中起作用。(C)2015年，Elsevier Inc. All rights reserved.
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. (C) 2015 by Elsevier Inc. All rights reserved.