The development of lacquer cracks in pathologic myopia

We examined three patients with pathologic myopia who had mild visual symptoms and subretinal hemorrhages. None had subretinal neovascularization. In all three patients, lacquer crack lesions of the choroid appeared shortly after clearing of the subretinal hemorrhages. The lacquer cracks were always more extensive than the preceding hemorrhages. These findings support the theory that mechanical stretching and rupture of the Bruch's membrane-pigment epithelium-choriocapillaris complex is the cause of these lesions. Fluorescein angiography helped differentiate these subretinal hemorrhages from those caused by subretinal neovascularization.