Choroidal Neovascularization Management in Angioid Streaks
Summary
Angioid streaks arise from breaks in Bruch’s membrane linked to systemic connective tissue disorders, most notably pseudoxanthoma elasticum. These fissures permit ingrowth of aberrant choroidal vessels beneath the retinal pigment epithelium, leading to choroidal neovascularization (CNV), haemorrhage and rapid central vision loss. Management aims to stabilise or improve visual acuity by inhibiting vascular proliferation and controlling exudation. Intravitreal administration of anti-vascular endothelial growth factor (anti-VEGF) agents has become the mainstay of therapy, demonstrating maintenance of functional outcomes over extended follow-up. Advances in multimodal imaging, particularly optical coherence tomography angiography (OCTA), have refined diagnosis, enabled early intervention and offered quantitative biomarkers predictive of recurrence. Emerging treatments under investigation include longer-acting VEGF inhibitors, gene therapy approaches to modulate extracellular matrix integrity and pharmacological stabilisers of Bruch’s membrane. Real-world data highlight the importance of personalised dosing regimens, patient adherence and surveillance for systemic risk factors associated with anti-VEGF therapy. Globally, improving access to modern imaging and anti-VEGF formulations remains critical to reducing the burden of vision impairment in affected populations.
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Choroidal Neovascularization Management in Angioid Streaks publication trend
The graph below shows the total number of articles in choroidal neovascularization management in angioid streaks across all publications each year (not limited to Nature Index journals).
Technical terms
Angioid streaks: Linear breaks in Bruch’s membrane visible as dark radiating lines around the optic disc.
Choroidal neovascularization (CNV): Pathological growth of new blood vessels from the choroid into the subretinal space.
Intravitreal injection: Direct administration of therapeutic agents into the vitreous cavity of the eye.
Anti-VEGF agent: Biologic or synthetic molecule that inhibits vascular endothelial growth factor, reducing neovascular proliferation.
Optical coherence tomography angiography (OCTA): Non-invasive imaging modality visualising retinal and choroidal microvasculature without dye injection.
References
- Long‐Term Effect of Anti‐Vascular Endothelial Growth Factor (Anti‐VEGF) Injections in Choroidal Neovascularization Secondary to Angioid Streaks. Journal of Ophthalmology (2022).
- Intravitreal Brolucizumab for Choroidal Neovascularization Associated to Angioid Streaks. Case Reports in Ophthalmological Medicine (2022).
- Long-term functional, anatomical outcome, and qualitative analysis by OCTA, as a predictor of disease recurrences in patients with choroidal neovascularization secondary to angioid streaks. International Journal of Retina and Vitreous (2024).
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