Fig. 10.1

Angioid streaks radiating from a ring around the optic disc. ‘Peau jj, d’orange’ is visible temporal to the macula.

Fig. 10.2

Macular scarring and angioid streaks in a 35- year-old man. No systemic associations were evident.

disease; skin biopsy for pseudoxanthoma elasticum; hemoglobin electrophoresis for sickle cell anaemia). Referral to a physician is often appropriate for investigation and management of these conditions.

Laser Treatment of choroidal neovascularization associated with angioid streaks is controversial. Focal laser treatment has been applied with the objective of stabilizing vision. Photodynamic therapy using verteporfin (see Age-related macular degeneration) is an area of current research.

Advice As minor trauma may cause rupture of the fragile Bruch’s membrane with its attendant complications, patients are best advised to avoid contact sports and to wear safety glasses in situations that expose them to potential ocular trauma. Review at 6-month intervals is recommended, with particular attention to the presence or progression of neovascularization. The patient may be supplied with an Amsler grid for use at home, and advised to report any change.

Angioid streaks