Angioid streaks are visible irregular crack-like dehiscences in an abnormal and calcified Bruch’s membrane that are associated with atrophic degeneration of the overlying retinal pigment epithelium. They appear as dark or reddish streaks originating from the optic disc, almost always bilaterally. Angioid streaks have been commonly associated with systemic conditions such as pseudoxanthoma elasticum (PXE), Paget’s disease, acromegaly, Marfan’s syndrome, Ehlers-Danlos syndrome and blood dyscrasias, but also appear in patients without any systemic disease. Patients with angioid streaks are generally asymptomatic, unless the lesions extend towards the fovea or develop complications such as traumatic Bruch’s membrane rupture or macular choroidal neovascularization. The authors present the cases of 5 patients with angioid streaks secondary to PXE.


Department of Ophthalmology of Hospital Pedro Hispano, Matosinhos, Portugal. Methods: Description of 5 clinical cases. All patients underwent complete ophthalmological examination including anamnesis, visual acuity (VA) assessment, slit lamp examination and fluorescein angiography (FA).


The authors present the cases of 5 women (with ages between 28 and 45 years) with Angioid streaks, all of them with diagnosis of PXE. Two of the patients had secondary macular choroidal neovascularization in one eye and underwent photodynamic therapy (one with VA improvement to final VA of 1/10 and the other with poor outcome: final VA of counting fingers). The other patients showed no symptoms or complications and present with VA of 10/10.


Angioid streaks can be associated with multiple systemic diseases and ophthalmologists must be aware of this condition and provide rapid treatment in case of ophthalmological complications. We also have to guide patients to a diagnostic survey for those discovered to have angioid streaks with no known systemic disease.