Tilted Optic Disc, Posterior Staphyloma, Zone Beta, and Lacquer Cracks

This fundus photograph of a 61 year old woman with pathologic myopia shows several abnormalities characteristic of this condition. The optic nerve enters the back of the eye which leads to the appearance of a tilted disc. The yellow arrow indicates the nasal border of the disc, which is in focus. The green arrow indicates the temporal border, which is out of focus because it is retrodisplaced relative to the nasal border. Zone beta refers to a retraction of the edge of the retinal pigment epithelium from the temporal edge of the optic disc. The blue arrows indicate this retracted edge in this case. This eye has a posterior staphyloma, which is an outpouching of the sclera. It can be appreciated in this case because the macular details are a bit out of focus. The stretched Bruch's membrane often develops some cracks, called lacquer cracks. Some of these are shown with the pink arrows.