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Survey of Ophthalmology 1982Angioid streaks are often associated with a systemic condition, most frequently pseudoxanthoma elasticum, Paget's disease of the bone, or one of the sickle... (Review)
Review
Angioid streaks are often associated with a systemic condition, most frequently pseudoxanthoma elasticum, Paget's disease of the bone, or one of the sickle hemoglobinopathies. The clinical manifestations of angioid streaks and those three systemic conditions are reviewed. A diagnostic survey is suggested for patients discovered to have angioid streaks with no known systemic disease. The results of such a survey in 50 patients are presented. In addition, separate studies of patients with Paget's disease of the bone (50 patients) and of the sickle hemoglobinopathies (100 patients) are described, and the characteristics of patients with angioid streaks as well as the incidence of streaks in these conditions is reviewed. The histopathologic and fluorescein angiographic characteristics of angioid streaks, as well as the possible benefit of photocoagulation for complications of angioid streaks is discussed.
Topics: Age Factors; Anemia, Sickle Cell; Angioid Streaks; Female; Fluorescein Angiography; Humans; Light Coagulation; Male; Osteitis Deformans; Pseudoxanthoma Elasticum; Retina
PubMed: 7046115
DOI: 10.1016/0039-6257(82)90158-8 -
Retina (Philadelphia, Pa.) Dec 2019
Topics: Angioid Streaks; Humans; Retina
PubMed: 31592884
DOI: 10.1097/IAE.0000000000002660 -
Retina (Philadelphia, Pa.) Dec 2019
Topics: Angioid Streaks; Humans
PubMed: 31592883
DOI: 10.1097/IAE.0000000000002661 -
Archives of Ophthalmology (Chicago,... Aug 1964
Topics: Angioid Streaks; Humans; Pseudoxanthoma Elasticum
PubMed: 14162955
DOI: 10.1001/archopht.1964.00970020264023 -
Journal Francais D'ophtalmologie Dec 2012Angioid streaks represent breaks in Bruch's membrane, appearing as dark or reddish radial streaks eminating from the optic disc. Usually asymptomatic, these streaks may... (Review)
Review
Angioid streaks represent breaks in Bruch's membrane, appearing as dark or reddish radial streaks eminating from the optic disc. Usually asymptomatic, these streaks may develop neovascularisation and lead to a maculopathy with marked loss of vision. Some associations with systemic disease are classically described, especially pseudoxanthoma elasticum. This condition may involve cardiovascular complications. A mutation has been found in the ABCC6 gene, which encodes for a membrane transport protein involved in the synthesis of the extracellular matrix. Imaging allows for visualization of the extent of the streaks, and autofluorescence is particularly informative. Spectral domain OCT may also demonstrate early breaks in Bruch's membrane. Neovascular complications, previously responsible for inevitable visual impairment at some point after their occurrence, are now managed by intravitreal injections of anti-VEGFs with clear efficacity. The ophthalmologist must be aware of this condition, in order to guide the patient towards a systemic work-up if necessary, and also to insure quick and targeted treatment in the case of neovascular complications.
Topics: Angioid Streaks; Bruch Membrane; Choroidal Neovascularization; Eye Hemorrhage; Hemoglobinopathies; Humans; Pseudoxanthoma Elasticum; Rupture, Spontaneous
PubMed: 23046745
DOI: 10.1016/j.jfo.2012.05.003 -
Retina (Philadelphia, Pa.) Jan 2019To stratify the literature on angioid streaks, from pathophysiology to treatment. (Review)
Review
PURPOSE
To stratify the literature on angioid streaks, from pathophysiology to treatment.
METHODS
Review of the current literature.
RESULTS
Angioid streaks are crack-like dehiscences of Bruch membrane, which may coexist with systemic diseases, such as pseudoxanthoma elasticum, Paget disease, Ehlers-Danlos syndrome, hemoglobinopathies, or other diseases of the collagen. Various diagnostic methods, including infrared and red-free retinography, autofluorescence, optical coherence tomography, fluorescein angiography, and indocyanine green angiography, are useful to diagnose, evaluate, and monitor angioid streaks. Choroidal neovascularization consists of a major complication of angioid streaks leading to visual impairment. Therefore, observation could not be a treatment option. Photodynamic treatment or anti-vascular endothelial growth factor agents have been used for the treatment of angioid streaks, offering promising but short-term results. Currently, the available treatment may limit the disease, but not permanently inactivate it.
CONCLUSION
This review discusses the epidemiology, pathophysiology, diagnosis, and treatment of angioid streaks, presenting the existing literature on this topic.
Topics: Angiogenesis Inhibitors; Angioid Streaks; Fluorescein Angiography; Fundus Oculi; Global Health; Humans; Incidence; Photochemotherapy; Retina; Tomography, Optical Coherence; Visual Acuity
PubMed: 30260918
DOI: 10.1097/IAE.0000000000002327 -
Australian Journal of Ophthalmology Feb 1983Angioid streaks were first described by Doyne in 1889. Gronblad proposed in 1929 that they followed disruption of the elastic layer of Bruch's membrane, having noted the...
Angioid streaks were first described by Doyne in 1889. Gronblad proposed in 1929 that they followed disruption of the elastic layer of Bruch's membrane, having noted the association between angioid streaks and pseudoxanthoma elasticum. Several other diseases have been associated with angioid streaks, including Paget's disease and sickle cell disease. Angioid streaks are found predominantly in the 20 to 50 year age-group and may be associated with minimal visual loss, but the problem is the high risk of rapid development of subretinal neovascularisation at the macula with resultant haemorrhage and scarring. Prophylactic light coagulation along the angioid streaks to prevent subretinal neovascularisation is not recommended. However, light coagulation treatment to foci of subretinal neovascularisation is possible if the network is not too close to fixation. As recurrence of neovascularisation is to be expected, very careful follow-up is necessary.
Topics: Adolescent; Adult; Aged; Anemia, Sickle Cell; Angioid Streaks; Child; Diagnosis, Differential; Female; Humans; Light Coagulation; Male; Middle Aged; Pseudoxanthoma Elasticum; Retinal Hemorrhage
PubMed: 6870682
DOI: No ID Found -
Retina (Philadelphia, Pa.) Jun 2010The purpose of this study was to report the visual outcome of intravitreal therapy with ranibizumab of choroidal neovascularization secondary to angioid streaks after...
PURPOSE
The purpose of this study was to report the visual outcome of intravitreal therapy with ranibizumab of choroidal neovascularization secondary to angioid streaks after 1-year follow-up.
METHODS
Nine patients (age, 58 +/- 4 years; range, 53-65 years) were treated with off-label intravitreal injections of 0.3 mg ranibizumab. Primary outcomes were best-corrected visual acuity changes (Early Treatment Diabetic Retinopathy Study logarithm of the minimum angle of resolution and letters) and optical coherence tomography macular thickness changes.
RESULTS
Mean follow-up was 14 months (+/-2; range, 12-18 months). Mean visual acuity was 0.52 logarithm of the minimum angle of resolution and 30 letters (range, 0.2-1.2; 0-47 letters) at baseline and 0.37 logarithm of the minimum angle of resolution (P = 0.014) and 37 letters (range, 0-1.2; 2-55 letters) (P = 0.01) at the last examination. Seven of 9 patients (78%) gained vision (mean, 2 lines), 1 patient (11 %) was stable, and 1 patient (11 %) lost 1 line of vision (5 letters). Two patients (22%) gained >or=3 lines of visual acuity, no patient lost >1 line. Mean optical coherence tomography macular thickness was 262.4 microm (+/-34.4 standard deviation) at baseline and 216.4 microm (+/-19 standard deviation) at the last examination (P = 0.05). The mean number of injection was 5 (range, 3-7); 78% of patients needed to be retreated after the loading dose of 3 monthly injections.
CONCLUSION
Ranibizumab can be considered as an effective therapy in angioid streak-related neovascularization, even if in an off-label setting.
Topics: Aged; Angiogenesis Inhibitors; Angioid Streaks; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Choroidal Neovascularization; Female; Humans; Injections; Male; Middle Aged; Ranibizumab; Retreatment; Treatment Outcome; Vascular Endothelial Growth Factor A; Visual Acuity; Vitreous Body
PubMed: 20531143
DOI: 10.1097/IAE.0b013e3181cafc75 -
QJM : Monthly Journal of the... Jul 2021
Topics: Angioid Streaks; Fluorescein Angiography; Humans; Pseudoxanthoma Elasticum
PubMed: 32502256
DOI: 10.1093/qjmed/hcaa190 -
Ophthalmology. Retina Jan 2021
Topics: Adult; Angioid Streaks; Female; Fluorescein Angiography; Fundus Oculi; Hemochromatosis; Humans; Retina
PubMed: 33413797
DOI: 10.1016/j.oret.2020.08.008