Multimodal imaging in eyes with angioid streaks: A retrospective, observational study

Abstract

Abstract Purpose: Early detection of angioid streaks (ASs) is important as it may lead to the diagnosis of life-threatening conditions such as Pseudoxanthoma elasticum, sickle cell disease, and Paget’s disease. This study aims to analyze multimodal imaging features and frequencies of various fundus findings associated with AS. Methods: This was a retrospective, observational, two-center study, in eyes with a diagnosis of AS. Consecutive patients of Angioid streaks were included in the study. Demographic data, best-corrected visual acuity, and various imaging characteristics on fundus photography, fundus fluorescein angiography, indocyanine green angiography, optical coherence tomography (OCT), and OCT angiography (OCTA) were used for analysis. Results: A total of 64 eyes of 32 patients, with a mean age of 50.5 ± 10.9 years, were included. Common fundus findings associated with AS included Peau d’orange appearance (100%), macular neovascularization (MNV) (70%), punched-out chorioretinal atrophy (CRA) patches (56%), and diffuse CRA patch (6%). OCT picked up areas of patchy outer retinal loss (88%), MNV, retinal pigment epithelium (RPE) nodularity (56%), and diffuse choroidal/RPE thinning. Eyes with MNV had a thinner choroid than those without MNV. OCTA showed varied degrees of choriocapillaris void areas in all eyes. Conclusions: Our study describes various clinical findings associated with AS along with their multimodal imaging features. MNV was found to be a very common complication of AS, which commonly presented with a thinner choroid.