Angioid Streaks

Abstract

Angioid streaks are irregular breaks in a calcified and thickened Bruch's membrane. They radiate outward from the optic nerve in a pattern similar to retinal vasculature. They are almost always bilateral, and here is no gender or racial predilection. They are not present at birth but may progress over time. Associated findings include optic disk drusen, peau d'orange, retinal hemorrhage, choroidal neovascularization and macular degeneration. The most common causes of vision loss in eyes with angioid streaks are choroidal neovascularization or macular degeneration. Systemic diseases are present in 50% of patients; most common are pseudoxanthoma elasticum Paget's disease, and the hemoglobinopathies. Most patients at diagnosis have relatively spared visual acuity, but over time a significant proportion of patients will develop vision worse than 20/200; however long-term outcomes in the era of intravitreal anti-vascular endothelial growth factor injections remain to be seen.