𝘈𝘯𝘨𝘪𝘰𝘪𝘥 𝘚𝘵𝘳𝘦𝘢𝘬𝘴 ● Bilateral ● Irregular linear breaks in the degenerated Bruch’s membrane ● Radiate from the optic disc in a cruciate pattern from an area of peripapillary pigment alteration ● Taper as they go away from the disc ● Pull of extraocular muscles create stress forces against the fixed point of the optic nerve which results in this pattern ● Colour varies from red to dark brown depending on the colour of fundus and overlying RPE atrophy ● Asymptomatic unless they involve macula
𝐀𝐬𝐬𝐨𝐜𝐢𝐚𝐭𝐞𝐝 𝐟𝐮𝐧𝐝𝐮𝐬 𝐜𝐡𝐚𝐧𝐠𝐞𝐬: ● Peau d’orange appearance - diffuse mottling of RPE representing focal defects in Bruch’s membrane and choriocapillaries ● Salmon spots - peripheral punched out focal yellowish atrophic RPE spots ● Optic disc drusen ● Fresh hemorrhages ● Cracked egg shell appearance - diffuse angioid streaks 𝐒𝐲𝐬𝐭𝐞𝐦𝐢𝐜 𝐀𝐬𝐬𝐨𝐜𝐢𝐚𝐭𝐢𝐨𝐧𝐬: 𝘗𝘌𝘗𝘚𝘐 Mnemonic: ● Pseudoxanthoma Elasticum ● Ehler- Danlos Syndrome ● Paget’s Disease ● Sickle Cell Anemia ● Idiopathic (50%) 𝐇𝐢𝐬𝐭𝐨𝐩𝐚𝐭𝐡𝐨𝐥𝐨𝐠𝐲: ● Extensive calcification and thickening of Bruch’s membrane and the intervening interstitial spaces between capillaries ● Elastic lamina affected ● Basophilic staining due to deposition of calcium seen with H&E 𝐂𝐨𝐦𝐩𝐥𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬: ● Choroidal neovascularisation ● Macular degeneration ● Traumatic membrane rupture ● RPE tears 𝐅𝐅𝐀: Window defect - Early hyperfluorescence with late staining www.ophthalmobytes.com Image from Rajan Eye Care Hospital #ophthalmology #ophthal #retina #angioidstreaks #choroidalneovascularisation #cnvm #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmologyresident #ophthalmologyresidency