|Year : 1977 | Volume
| Issue : 3 | Page : 37-39
Nehru Institute of Ophthalmology and Research and Eye Hospital, Sitapur, India
A K Paul
Nehru Institute of Ophthalmology and Research, Eye Hospital, Sitapur
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Paul A K. Angioid streaks. Indian J Ophthalmol 1977;25:37-9
Angioid streaks are peculiar and characteristic bilateral condition in the fundus due primarily to degenerative changes affecting particularly the elastic lamina which constitutes the mesodermal component of Bruch's membrane. This condition is frequently associated with more widespread degenerative changes in the elastic tissue elsewhere including internal elastic lamina of the arteries, senile elastosis of skin, pseudo xanthoma elasticum, fibrodysplasia hyperelastica, osteitis deformans, cardiovascular disease with hypertension and sickle cell disease.
| Case report|| |
A 46 years old female was admitted at the Eye Hospital, Sitapur on 14.10.1975 with the complaint of dimness of vision. She was found to have widespread pseudo xarithoma elasticum [Figure - 1]. Her skin condition had begun since childhood and has been slowly progressive. There was no family history of such condition. Her general health was otherwise normal.
| Examination|| |
Visual acuity in the right eye was 6/60 and in the left eye was 6/36. The corrected visual acuity was 6/12 in the right eye and 6/9 in the left eye. The external and slitlamp appearances were normal.
Ocular tension was 17.3 mm Hg. in each eye. The fundus examination showed the picture characteristic of angioid streaks in both eyes. There were network of dark brown streaks mostly around the optic disc. Some irregular streaks were also seen at the periphery of the fundus. The foveal reflex was dull and there were pigmentary changes in the macular areas. There were no abnormalities in the optic discs and the retinal blood vessels.
| Fluorescein angiography|| |
From the arterial phase the peripapillary irregular ring is visible [Figure - 2]. Staining is more marked during arteriovenous and venous phase [Figure - 3],[Figure - 4]. The staining pattern is interrupted by dark area and shows in some places a narrowing of the streak. The angioid streaks were more prominent with the passage of time and it was noticed that fluorescein staining of the streak persisted for some time after the retinal vessels had become clear for the dye [Figure - 5][Figure - 6].
| Discussion|| |
The clinical condition of the angioid streaks is characterised by wide spread network of streaks of varying colour seen around the disc and sometime at periphery of the fundus. There are also wide degenerative changes seen elsewhere in the body. The true pathological nature is obscure. This varied from breaks in Bruch's membrane, abnormal choroidal vessels, breaks in Bruch's membrane allowing normal choriocapillaries to be seen, to breaks in Bruch.s membrane with ingrowth scar tissue. The fluorescein pattern of the condition is characteristic. The persistant flourescence is described on fluorescein fundus photography. The angioid streaks stain with arterial phase. Fluorescein persists beyond the late phase and is visible for some time after complete drainage of the dye from the vessels.
| Summary|| |
A typical case of angioid streaks with pseudoxanthoma elasticum and a characteristic fluorescein fundus photograph are presented.
| References|| |
Duke Elder, System of Ophthalomology 721,
Henry Kimpton, London.
Smith J.L., J.D.M., Gass, J. Justice 1964. Brit. J. Ophthal., 48 517.
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5], [Figure - 6]