Angioid streaks

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.