What are the other Names for this Condition? (Also known as/Synonyms)

• Knapp Streaks
• Knapp Striae

What are Angioid Streaks? (Definition/Background Information)

• Angioid Streaks is a mostly asymptomatic retinal condition involving both the eyes, and characterized by the presence of irregular thin lines/streaks radiating out of the optic disc (circular region inside the back of the eye, where optic nerve connects the retina)
• Angioid Streaks usually develop secondary to certain systemic conditions, such as pseudoxanthoma elasticum (most commonly), sickle cell disease, and Ehlers Danlos syndrome, including eye injury

Who gets Angioid Streaks? (Age and Sex Distribution)

• Individuals of any age category including children and adults may present Angioid Streaks
• Both males and females may be affected
• Worldwide, individuals of all races and ethnicity are prone to developing the condition

What are the Risk Factors for Angioid Streaks? (Predisposing Factors)

The risk factors for Angioid Streaks may include:

• Abetalipoproteinemia
• Acromegaly
• Ehlers-Danlos syndrome
• Facial angiomatosis
• Hemochromatosis
• Hemolytic anemia
• Lead poisoning
• Neurofibromatosis
• Paget's disease of bone
• Pseudoxanthoma elasticum - the most common cause for Angioid Streaks
• Senile elastosis
• Shortsightedness
• Sickle cell disease
• Sturge-Weber syndrome
• Trauma to the eye
• Tuberous sclerosis
• Type 2 diabetes

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Angioid Streaks? (Etiology)

The cause of Angioid Streaks is not clearly understood in nearly 50% of the cases (idiopathic Angioid Streaks).

• In the remaining cases, Angioid Streaks develop from an underlying condition, such as pseudoxanthoma elasticum or sickle cell disease, due to weakening of the Bruch's membrane (in the choroid), which causes narrow irregular streaks radiating out of the optic disc
• The Bruch's membrane forms the innermost layer of the choroid. The choroid, lying between the retina and the sclera, is a portion of the uvea (part of the eye structure) that is predominantly made up of blood vessels. The choroid provides nutrients to the retina keeping it healthy

What are the Signs and Symptoms of Angioid Streaks?

In general, Angioid Streaks does not present any significant signs and symptoms. However, signs and symptoms of the underlying causative condition may be noted.

How are Angioid Streaks Diagnosed?

Angioid Streaks may be diagnosed by the following observations and tests:

• Physical examination and medical history evaluation (including history of any recent illness or other conditions)
• Assessment of signs and symptoms
• General eye exam
• Fundoscopic (ophthalmoscopic) examination by an eye specialist, who examines the back part of the eye (or the fundus)
• Visual acuity test using a special and standardized test chart (Snellen chart)
• Slit-lamp examination
• Visual evoked potential (VEP) test
• Fundus fluorescein angiography is important in diagnosing Angioid Streaks
• Indocyanine green (ICG) angiography

Tests and procedures to diagnose the underlying condition is important.

A differential diagnosis to eliminate other conditions may be considered, before arriving at a definitive diagnosis. These may include:

• Central serous chorioretinopathy
• Choroidal rupture
• Histoplasmosis
• Metastatic choroidal tumor
• Myopic degeneration
• Toxoplasmosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Angioid Streaks?

No significant complications of Angioid Streaks are typically noted. However, in some cases, it may be observed with the following conditions:

• Choroidal neovascularization (CNV) that may become chronic and result in vision loss
• Scarring of the optical disc
• There is an increased risk for retinal bleeding (subretinal hemorrhaging) even with minor eye trauma

Complications may arise from the underlying causative condition.

How are Angioid Streaks Treated?

Generally, no treatment measures are required for Angioid Streaks.

• A wait and watch approach is usually considered by the healthcare provider
• Treating the underlying condition forms an important part of managing the condition
• In case of complications, such as choroidal neovascularization, intravitreal anti-VEGF treatment may be considered

How can Angioid Streaks be Prevented?

Presently, it is difficult to prevent Angioid Streaks. However, the following factors may help reduce one’s risk for developing the same:

• Undertake early and adequate treatment of any health issues
• Adopting a healthy lifestyle and avoid stress

Regular eye checkups are recommended, especially following a diagnosis of Angioid Streaks.

What is the Prognosis of Angioid Streaks? (Outcomes/Resolutions)

• The overall prognosis of Angioid Streaks depends on the severity of the underlying condition, the presence of any complications, and overall health status of the individual.
• In case a diagnosis of Angioid Streaks is established, adequate safety measures must be taken to protect the eye from further damage and worsening of the condition

Additional and Relevant Useful Information for Angioid Streaks:

Please visit our Eye & Vision Health Center for more physician-approved health information:

https://www.dovemed.com/health-topics/vision-center/