This 54YO highly myopic female is being followed with PRN Avastin injections in her left eye for myopic macular neovascularization. She was asymptomatic, and vision was stable at 20/50 OD and 20/60 OS.
Optos color RGB imaging of her right macula shows numerous lacquer cracks. Triton swept-source OCT shows outer retinal and RPE loss with increased choroidal transmission. Remarkably, her macula was normal one year earlier. Continued observation was recommended.
Learning Points:
Lacquer cracks are a common finding in patients with high myopia. They consist of breaks in Bruch’s membrane due to the outpouching/stretching of the pathologically myopic eye and increase the risk for macular neovascularization. Acutely, they are often associated with avascular subretinal blood, which resolves with observation.
