DOT BLOT HEMORRHAGES CRACK

DOT BLOT HEMORRHAGES CRACK

Leakage of fluorescein may be noted occasionally in these lacquer crack areas, particularly if there is a Fuchs' fleck. At the site of the pseudoangioid streaks, there is mostly hyperfluorescence, which is due to pigment epithelial atrophy. The ophthalmoscopic abnormality determines what kind of fluorescence abnormalities are seen. However, in a few of these patients, the retinal hole appears to be at the site of the macula. Holes are not infrequently found in the periphery of these retinas retinal detachment is therefore often seen. The retinal periphery often shows pigmentary changes and may show areas of lattice-like and snail-track degeneration. Ultimately, large areas of chorioretinal atrophy may be found in the posterior pole of the eye. Pseudoholes of the macula may result from vitreoretinal traction. 64-38) occur and may lead to macular hemorrhage (Fuchs' fleck) ( Fig. Then, owing to cracks in Bruch's membrane, pseudoangioid streaks (lacquer cracks) ( Fig. 64-37) occurs early, and pigmentary changes in the macula may be seen. Peripapillary chorioretinal atrophy ( Fig. A generally blond fundus renders the choroidal vessels visible. Initially there are, in the main, no distinct ophthalmoscopic changes except for a myopic crescent. Gradual visual loss and metamorphopsia may result from breaks in Bruch's membrane. Sudden visual loss may occur as a result of macular hemorrhage at the site of the fovea when Bruch's membrane decompensates (Fuchs' fleck). The refractive error dominates the clinical picture. Because this condition often leads to extensive macular changes, it is worthwhile to present the most common fundus abnormalities in this disease. Hereditary factors are frequently involved in high myopia. van Lith-Verhoeven, in Retina (Fourth Edition), 2006 High myopia In some cases, the fovea could be partially masked by deep macular hemorrhages ( Figure 13-6).Īugust F.

Close follow-up with FA and eventually with scanning laser ophthalmoscope ICG angiography is particularly useful for detecting complications. Hemorrhages may recur in the same or in another location with extension of the cracks, increasing the risk of CNV development ( Figure 13-5A–C). When not associated with CNV, hemorrhages usually resolve in nearly all cases with a good prognosis. In the absence of choroidal neovascularization, there is no hyperfluorescence, even in late ICG angiography. On FA, the hemorrhages may totally obscure the crack, but ICG angiography may help detect the rupture in the Bruch's membrane underlying the hemorrhage. There is no associated serous retinal detachment. Subretinal hemorrhages are frequently focal, dense, round, deep, and often centered on the fovea, associated with the occurrence or the extension of a lacquer crack. Macular hemorrhages are associated with lacquer cracks in more than 95% of cases, mostly along the crack itself and near from the center of the fovea or in its immediate vicinity ( Figure 13-4A and B). These hemorrhages may occur in the absence of choroidal neovascular membrane. The occurrence or extension of a lacquer crack can be associated with a macular hemorrhage. GABRIEL COSCAS MD, GISÈLE SOUBRANE MD, PhD, FEBO, in Retinal Imaging, 2006 13.2.3 MACULAR HEMORRHAGES

Dot blot hemorrhages