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Angioid Streaks Follow-up

  • Author: Mohammad Abusamak, MD; Chief Editor: Hampton Roy, Sr, MD  more...
Updated: Feb 20, 2014

Further Outpatient Care

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  • Screening and follow-up examination by means of Amsler grid and ophthalmoscopic examination, including FA, may be necessary to detect CNVM and to treat recurrences.
  • Patients who undergo laser treatment or surgery need close follow-up care during the first 3 months of treatment. If they stay asymptomatic and no FA leakage occurs, follow-up care every 6 months is recommended.


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  • Subretinal hemorrhage and serous detachment are common complications of angioid streaks. Incidence of subretinal hemorrhage and serous detachment caused by choroidal neovascularization is high, about 85% of all patients with PXE and 10-15% of patients with Paget disease of the bone. The disease is bilateral in all patients with an average age of onset older than 25 years.


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  • A high risk of serious complications, such subretinal hemorrhage and serous detachment, exists. Bilateral involvement is the rule, although it may not be symmetrical. Families with affected individuals need screening and regular eye examinations for early detection of any progression.

Patient Education

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  • Patients should be instructed to return if visual acuity decreases. Signs of decreased central visual acuity may include central blurred vision, difficulty in depth perception, and distortion of lines and objects.
  • Families and patients will benefit from using an Amsler grid to detect early changes in asymptomatic but high-risk individuals.
  • More emphasis should be placed on safety measures to avoid trauma even if trivial. Protective goggles are useful for young patients who participate in sports.
Contributor Information and Disclosures

Mohammad Abusamak, MD Chief of Retina Division, Jordan University Hospital; Assistant Professor, Division of Ophthalmology, University of Jordan Faculty of Medicine; Ophthalmologist, Amman Eye Clinic, Jordan

Mohammad Abusamak, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Steve Charles, MD Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Macula Society, Retina Society, Club Jules Gonin

Disclosure: Received royalty and consulting fees for: Alcon Laboratories.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Russell P Jayne, MD Consulting Vitreoretinal Surgeon, The Retina Center at Las Vegas

Russell P Jayne, MD is a member of the following medical societies: American Medical Association, American Society of Cataract and Refractive Surgery, American Society of Retina Specialists

Disclosure: Nothing to disclose.

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Progression of angioid streaks. Large subretinal hemorrhage.
Same eye as in previous image, 11 months later. Partial resolution of subretinal blood. Notice the old subretinal hemorrhage under the fovea and color change to white-yellow.
Late complication of choroidal neovascularization in angioid streaks. Same eye as in previous images, 5 years later. Notice the extensive scarring and subretinal exudates and dehemoglobinized blood.
Red-free photograph of the optic nerve and posterior pole showing the cracks in the Bruch membrane. Notice the retinal arteries and veins crossing over the dark red streaks.
Early fluorescein angiography showing the early hyperfluorescence, window defect, of the angioid streaks.
Late fluorescein angiography of the same eye as in Media file 2. Notice the staining of the edges of the streaks. Also, staining in the center of the macula is present due to extension of the Bruch membrane crack. When compared to early fluorescein angiography, no active leakage is present.
Right eye, midphase arteriovenous, showing choriocapillaris atrophic changes. This 45-year-old patient underwent 3 injections of Avastin and one session of half-time photodynamic therapy.
Same patient as in previous image, a few months before the Avastin injection and half-time photodynamic therapy.
A 50-year-old man with a 2-month history of blurring vision in the left eye. The color photograph showed subretinal blood and large membrane, extrafoveal in location.
Early fundus fluorescein angiography showing the hyperfluorescence of the choroidal neovascular membrane of the left eye of the same patient in the previous image.
Late fundus fluorescein angiography confirming the active choroidal neovascular membrane of the left eye.
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