What you should know about angioid streaks by david j. From the files of two retinal referral practices, five patients were located in whom lacquer cracks developed or expanded after laser photocoagulation for macular cnv in pathologic myopia. Apr 15, 1987 myopic cracks, angioid streaks, and traumatic tears in bruchs membrane. Angioid streaks and optic disc drusen in pseudoxanthoma. Although uncommon, angioid streaks often have a systemic cause and warrant. Angioid streaks, clinical course, complications, and current. Progressive symmetric vertical macular wide angioid streaklike. A series of images acquired across the macular area. These streaks can have a negative impact on vision due to choroidal neovascularization or choroidal rupture. Apr, 2020 angioid streaks are bilateral, narrow, irregular lines deep to the retina configured in a radiating fashion emanating from the optic disc, which result from breaks in a weakened bruchs membrane.
Macular choroidal thickness and volume in eyes with angioid streaks measured by swept source oct 1. Apr 07, 2004 angioid streaks, which are cracks in bruchs membrane, are one of the possible ocular sequelae of hemochromatosis. In many cases, however, these fine cracks in the membrane expand, leading to visual impairment. Angioid streaks usually emanate from the disc, tend to be straighter, and are reddish in color. Peripheral lacquer cracks as an early finding in pathological.
May 23, 2019 angioid streaks are a retinal condition characterized by breaks and cracks in bruchs membrane, the lower layer of the retina that helps feed and nourish the overlying photoreceptor layer. Lacquer cracks are breaks seen in the peripheral fundus of the eyes of people with high myopia. Knapp, md, a germanborn american ophthalmologist, as the conversion of extravasated blood into streaks of dark brown or black pigment in the retina. If you have angioid streaks in one or both eyes, it is possible to remain asymptomatic and maintain perfect vision for a long time. Named because of their resemblance to blood vessels. Angioid streaks, which are cracks in bruchs membrane, are one of the possible ocular sequelae of hemochromatosis. Patients with angioid streaks are prone to developing subretinal hemorrhage after ocular or head injury due to the brittleness of bruchs membrane. Jul 22, 2019 in 1889, doyne first described angioid streaks in a patient with retinal hemorrhages secondary to trauma. Jul 22, 2019 a preliminary study of photodynamic therapy using verteporfin for choroidal neovascularization in pathologic myopia, ocular histoplasmosis syndrome, angioid streaks, and idiopathic causes.
Myopic cracks, angioid streaks, and traumatic tears in. Angioid streaks, also known as knapp striae, are irregular jagged dehiscences in the mineralized, degenerated, brittle bruch membrane that typically form alongside force lines exerted by intrinsic and extrinsic ocular muscles that radiate in a centrifugal pattern emanating from the. Jun 16, 2012 7 ohnomatsui k, yoshida t, futagami s, et al. Proceeding from the inside of the eye to the outside, the layers are as follows. Angioid streaks usually do not extend past the equator. A preliminary study of photodynamic therapy using verteporfin for choroidal neovascularization in pathologic myopia, ocular histoplasmosis syndrome, angioid streaks, and idiopathic causes. They are termed angioid streaks for their resemblance to retinal vasculature. For several years the appearance of angioid streaks in sicklecell hemoglobinopathies was attributed to high level of serum iron.
Choroidal ruptures, on the other hand, share with lacquer cracks similar distribution, color, and fluorescein angiographic. Patchy atrophy and lacquer cracks predispose to the development of choroidal neovascularization in pathologic myopia. Choroidal ruptures, similar distribution, color, and fluoresceinangiographic appearance to lc, but are caused by a traumaticevent. The reported clinical impression then was myopic chorioretinal degeneration versus lacquer crackassociated myopic degeneration. Myopic cracks, angioid streaks, and traumatic tears in bruchs membrane. Jul 08, 2014 a series of images acquired across the macular area. Bruchs membrane can thicken, calcify and begin to crack. Jun 01, 2007 lacquer cracks are clinically noted in 4. Lacquer cracks were found in a reticular distribution within a posterior staphyloma. They may also occur idiopathically or in association with myopia, ehlersdanlos syndrome, pseudoxanthoma elasticum, pagets disease, marfans syndrome and sicklecell disease. May 15, 2018 angioid streaks are visible cracklike breaks in bruchs membrane due to an atrophic overlaying retinal pigment epithelium. Angioid streaks may be associated with pseudoxanthoma elasticum, pagets disease, sicklecell anemia, acromegaly, ehlersdanlos syndrome, and diabetes mellitus, but also appear in patients without any systemic disease. Patients with angioid streaks have an increased risk of developing hemorrhages associated with trauma because of the rupture of the choroid. If you continue browsing the site, you agree to the use of cookies on this website.
Retinal pigment epithelium a layer of cells which recycles. Lacquer cracks are present in high myopia and can lead to choroidal neovascularisation and macular haemorrhage, which in turn can cause central visual loss but it is not very common. The streaks run a convoluted course and tend to terminate abruptly. There are a number of potential causes of angioid streaks, including pseudoxanthoma elasticum, ehlerdanlos syndrome, pagets disease, sickle cell disease, and other hemoglobinopathies paton, 1972. Angioid streaks are orange, red, grey or brown in color and can be confused for retinal blood vessels on superficial examination. Angioid streaks are bilateral, narrow, irregular lines deep to the retina configured in a. Angioid streaks differential diagnoses medscape emedicine. Choroidal rupture is a break in the retinal pigment epithelium, bruchs membrane, and throughout the choroid. Three diseases that involve bruchs membrane give somewhat similar fundus appearance in different clinical settings. Nov 01, 2011 the name angioid streaks was coined in 1892 by herman j.
Regarding autofluorescence, angioid streaks appear as fissures with central hypoautofluorescence and with a variable amount of hyperautofluorescence at the borders of the cracks figure 3. Angioid streaks synonyms, angioid streaks pronunciation, angioid streaks translation, english dictionary definition of angioid streaks. Choose from 212 different sets of macula flashcards on quizlet. Lacquer cracks vs angioid streak vs choroidal rupture all three diseased statesof bruchs membrane angioid streaks emanate radially from disc, are straighter,and are reddish in color. They radiate from the optic nerve and can have a peau dorange appearance originating from the macula and extending temporally figures 1 and 2. Retina a nerve lining which converts light into nervous impulses. The reported frequencies of angioid streaks in pseudoxanthoma elasticum vary tremendously with the era of the observer, the specialty dermatology, genetics, ophthalmology, etc. In 1889, doyne first described angioid streaks in a patient with retinal hemorrhages secondary to trauma. Angioid streaks are evident in fundoscopy a few millimetres from the optic disc and rarely occur in the periphery of the posterior pole. Lacquer cracks following laser treatment of choroidal. Macular choroidal thickness and volume in eyes with angioid. Lacquer cracks are often mistaken for angioid streaks. Angioid streaks are visible cracklike breaks in bruchs membrane due to an atrophic overlaying retinal pigment epithelium.
Lacquer cracks vs angioid streak vs choroidal rupture. Angioid streaks appear in bruchs membrane and are linked to atrophic degneration of the retinal pigment epithelium. Choroidal neovascularization in angioid streaks following. Peripheral lacquer cracks as an early finding in pathological myopia. Also break or absence of choriocapillaris beneath the angioid streaks as associations.
We studied the pattern of break formation in 60 eyes with myopic lacquer cracks, angioid streaks, or traumatic tears in bruchs. Improving differential diagnosis of angioid streaks. Lacquer cracks must be differentiated from 2 similar diseases of bruch membrane, namely angioid streaks and choroidal ruptures. Angioid streaks are visible irregular cracklike dehiscences in bruchs membrane associated with atrophic degeneration of the overlying retinal pigmented epithelium.
Angioid streaks are a retinal condition characterized by breaks and cracks in bruchs membrane, the lower layer of the retina that helps feed and nourish the overlying photoreceptor layer. Mim607140 calcification of lamina basalis choroideae visible in the peripapillary fundus oculi. Browning, md, phd the eye wall has several layers, as shown in figure 1. Prevalence and characteristics of foveal retinal detachment without macular. Asim wasim slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Description high myopia is defined as myopia greater than 6 diopters and an axial length of 26. No drusen or other signs of amd were evident figure 1. Lacquer cracks are uncommon findings in the posterior pole of highly myopic.
Look for lacquer cracks in high myopes for early warning. We report herein a patient with angioid streaks who developed choroidal neovascularization after. Angioid streaks medigoo health medical tests medical. At least 50% of all individuals with pxe demonstrate angioid streaks. Retinal physician easily misdiagnosed retinal entities. This study examined lacquer cracks as a possible consequence of laser photocoagulation of cnv. The cracks appear as thick, brown or grayish lines that radiate from the area around the optic nerve. Myopic cracks, angioid streaks, and traumatic tears in bruchs. Mar 26, 2009 angioid streaks are evident in fundoscopy a few millimetres from the optic disc and rarely occur in the periphery of the posterior pole. We studied the pattern of break formation in 60 eyes with myopic lacquer cracks, angioid streaks, or traumatic tears in bruchs membrane, using a graphics composition technique and computer analysis of digitized images. Ophthalmologists should be aware that there are numerous systemic diseases associated with angioid streaks, the most common being pseudoxanthoma elasticum. The beginning stages of posterior staphylomas are very difficult to discern on physical exam for runofthemill retinal specialists or general ophthalmologists. Myopic stretch lines linear lesions in fundus of eyes with.
Color photographs showed areas of yellowish opacification that obscured. Improving differential diagnosis of angioid streaks retinal physician. Seen with pseudoxanthoma elasticum most commonly, ehlers danlos syndrome, pagets disease, sickle cell anemia, or idiopathic pepsi. Angioid streaks definition of angioid streaks by the free. Retinal photos quiz at pacific university studyblue. Progressive symmetric vertical macular wide angioid streak. Myopic cracks, angioid streaks, and traumatic tears in bruch. Macular choroidal thickness and volume in eyes with angioid streaks measured by swept source optical coherence tomography abdallah a. Etiology angioid streaks result from cracklike breaks in bruchs membrane, which is abnormal in its structural composition, predisposing to these localized areas of rupture. Advances in ocular imaging devices including optical coherence tomography, ultrasound, and magnetic resonance imaging have enabled the visualization of pathological myopia characterized by the excessive elongation of the eye, thereby identifying microscopic changes ranging from the posterior segment sclera, choroid, retina, andor the optic nerve to the anterior segment. Clinically, they appear as fine, irregular yellow lines, single or multiple, linear or stellate, often branching and crisscrossing at the posterior pole, usually within an area of staphyloma.
They are caused by a breakdown in the collagen and elastic lamina of bruchs membrane. Angioid streaks definition of angioid streaks by medical. Resultsthe lacquer cracks progressed in 37 eyes 56. Pathologic or degenerative myopia is defined as high myopia with any posterior myopiaspecific pathology from axial elongation. Lacquer cracks have also been as cribed to either a degenerative process of bruchs membrane akin to angioid streaks or sclerosis of the choroidal vessels. Optical coherence tomography images were evaluated for reflectivity pattern of the band corresponding to the retinal pigment epitheliumbruch membrane complex. Choroidal ruptures, similar distribution, color, and fluoresceinangiographic appearance to. Angioid streaks have also been called as knapp streaks or knapp striae in. Look for lacquer cracks in high myopes for early warning of.
They may also occur idiopathically or in association with myopia, ehlersdanlos syndrome, pseudoxanthoma elasticum, pagets. However, there have been no reports of any angioid streak patients in whom choroidal neovascularization occurred after vitrectomy surgery. Methodsthe authors studied 66 eyes 53 patients with lacquer cracks, using general ocular examinations and fluorescein angiography once every 3 to 12 months. Angioid streaks are often associated with pseudoxanthoma elasticum, but have been found to occur in conjunction with other disorders, including pagets disease, sickle cell disease and ehlersdanlos syndrome. Lacquer crack lesions in pathologic myopia sciencedirect. Study 39 retinal photos quiz flashcards from jake b. Angioid streaks are orange, red, grey or brown in color and can be confused for. We report herein a patient with angioid streaks who developed choroidal neovascularization after vitrectomy.