Jonas, Rahul A., Wei, Chuan Chuan, Jonas, Jost B. and Wang, Ya Xing (2021). Decreasing myopic lacquer crack and widening parapapillary gamma zone: case report. BMC Ophthalmol., 21 (1). LONDON: BMC. ISSN 1471-2415

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Abstract

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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Jonas, Rahul A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wei, Chuan ChuanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jonas, Jost B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wang, Ya XingUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-583845
DOI: 10.1186/s12886-021-02216-7
Journal or Publication Title: BMC Ophthalmol.
Volume: 21
Number: 1
Date: 2021
Publisher: BMC
Place of Publication: LONDON
ISSN: 1471-2415
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
BRUCHS MEMBRANEMultiple languages
OphthalmologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/58384

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