Title

ANGIOID STREAKS: CASE REPORT

Introduction

Angioid streaks (AS) are bilateral, narrow, irregular, and deep radiations in the retina, being wider at the origin of the optic nerve and reducing in as they branch. They result from defects in the Bruch's membrane, which lead to calcifications and thickening of it. It is associated with systemic diseases such as elastic pseudoxanthoma, Ehlers-Danlos, Paget's disease and hemoglobinopathies. The diagnosis is clinical and can be confirmed with the aid of fluorescein angiography (AF). They are asymptomatic, when not associated with complications, such as intrarretinal hemorrhages and choroidal neovascularization (CNV). These complications must be rapidly identified and treated, in order to prevent visual loss.

Methods

Medical record review.

Results

A 76-years-old female patient. Her best corrected visual acuity (BCVA) was 20/100 in the right eye and 20/50 in the left eye. Dilated fundus examination of the right eye revealed areas of fibrotic macular scars and radial dark-brown lines emerging from the optic disc. Some small intreretinal hemorrhages were seen in the posterior pole of the left eye. AS could be observed bilaterally. The FAF showed hyperautofluorescent lines in a radiating fashion emanating from the optic nerve. We ruled out systemic conditions related with AS. We chose to keep monitoring her every six months with fundoscopy and complementary exams to detect any associated complications.

Discussion

Despite being generally asymptomatic, and therefore not requiring specific treatment, AS can lead to complications. CNV result from the growth of a fibrovascular tissue from the choroid to the retinal pigmented epithelium, causing subretinal hemorrhages and fluid accumulation, which is responsible for visual loss. We highlight the importance of follow-up to determine whether there are associated systemic diseases or secondary eye complications, which require medical approach and treatment.

Keywords

Angioid streaks; Retinal diseases.

Area

CLINICAL CASE

Authors

Andréia Novelli, Rafael Garcia, Paulo Henrique Horizonte, Henrique Monteiro Leber, Nathalia N Tondelli, Raimunda Cristina M F De Oliveira, Leonardo Benedito Cardoso, André Marcelo Vieira Gomes