Lacquer crack lesions in pathologic myopia

In evaluating the anatomic and functional status of 22 eyes of 14 patients demonstrating lacquer cracks, these lesions occurred in the eyes of young adults with posterior staphylomas and markedly increased axial lengths. Decreased visual acuity and altered visual fields were the rule; choroidal hemorrhage and focal chorioretinal atrophy were less frequently associated. Fluorescein angiography revealed early and late pseudofluorescence and late staining of the lesions. These clinical data suggest that lacquer cracks represent healed, mechanical breaks in the pigment epithelium-Bruch's membrane-choriocapillaris complex. The presence of these lesions implies a guarded prognosis for the retention of central vision.