Lacquer crack formation and choroidal neovascularization in pathologic myopia.
OBJECTIVE
To clarify the characteristics of choroidal neovascularization (CNV) due to myopic CNV (mCNV) and the relation to lacquer crack (LC) formation.


METHODS
Thirty-seven eyes with mCNV underwent fluorescein angiography (FA) and indocyanine green angiography (ICGA) using Heidelberg Retina Angiograph 2 (HRA2; Heidelberg, Germany). mCNV was detected by FA and ICGA; LCs were detected by late-phase ICGA.


RESULTS
Thirty-five eyes (95%) had classic mCNV, and 2 (5%) had occult CNV. LCs developed in 35 (95%) of 37 eyes. In 33 eyes (94%), classic mCNV originated from LCs; the 2 other eyes had small horizontal dotlike LCs, but mCNV originated from the adjacent area of LC. No occult CNV was associated with LCs. Two morphologic types of LCs were observed, linear (21 eyes [62%]) and stellate (12 eyes [32%]) from which mCNV originated, with no significant differences in parameters between the two types. Classic mCNV demonstrated well-delineated hyperfluorescence by late-phase ICGA in 10 eyes (29%), which was significantly correlated with absence of a dark rim (P = 0.022).


CONCLUSIONS
ICGA using HRA2 provides more detailed information on mCNV and LCs. LC formation is essential for classic mCNV to develop. Morphologic variations of LCs were not different clinically. Late-phase hyperfluorescence, probably due to the absence of pigment epithelium around the mCNV, may represent its activity.
Ikuno
Yasushi
Y
Department of Ophthalmology, Osaka University Medical School, Osaka, Japan. ikuno@ophthal.med.osaka-u.ac.jp
Sayanagi
Kaori
K
Soga
Kaori
K
Sawa
Miki
M
Gomi
Fumi
F
Tsujikawa
Motokazu
M
Tano
Yasuo
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology*; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications*
D004396:Coloring Agents; D007208:Indocyanine Green