The blood-retinal barrier in angioid streaks

The blood retinal barrier was investigated in a group of patients with angioid streaks and pseudoxanthoma elasticum, using the technique of vitreous fluorophotometry. Angioid streaks are breaks in the elastic layer of Bruch's membrane with atrophy of the adjacent pigment epithelium. The retinal pigment epithelial cells and their intercellular junctions form part of the blood retinal barrier. In this study, it was found that despite the presence of angioid streaks and extensive areas of pigment epithelial atrophy the blood retinal barrier was intact. In contrast, when disciform degeneration had occurred the blood retinal barrier was abnormal. It is proposed that vitreous fluorophotometry could be used to identify those patients developing disciform degeneration at an early and therefore potentially treatable stage.