UMDNJ-NJMS Ophthalmology: Case of the Month

UNIVERSITY OPHTHALMOLOGY CONSULTANTS

CASE OF THE MONTH

CASE #4

DISEASES OF THE RETINA AND MACULA

Angioid streaks appear as irregular, jagged, linear lesions radiating from the peripapillary area. They tend to have a circumferential pattern around the optic nerve head. They can resemble blood vessels, thus the term “angioid.” Histologically, angioid streaks are dehiscences in the collagenous and elastic layers of Bruch’s membrane, which often shows calcific degeneration.
	Angioid streaks
Fibrovascular tissue can grow from the choroid through the break, obscuring the angioid streak, as is seen in this patient’s right eye just superior to the optic disc.
	Subretinal fibrosis

Choroidal neovascularization can grow from angioid streaks and will cause visual loss if the macula is involved. Because Bruch’s membrane is brittle in this condition, patients with angioid streaks should be cautioned that minor trauma can precipitate choroidal rupture, subretinal hemorrhage, and visual loss. Patients with angioid streaks probably should wear extra eye protection (eg, polycarbonate lenses, impact-resistant goggles), if they participate in games such as squash, tennis, or contact sports. Scleral depression can precipitate choroidal rupture. Angioid streaks are commonly associated with systemic diseases (50% of the time in one study). The most common associated conditions are pseudoxanthoma elasticum, sickle cell disease, Paget’s disease, and Ehlers-Danlos syndrome.

	Previous page	Next page