Optical coherence tomography angiography features of angioid streaks_Chinese Journal of Ocular Fundus Diseases

Authors：

Li Hua , Zhang Juan , Zhang Liwei , Jiao Kangwei ,  Li Juanjuan

Department of Ophthalmology, Yunnan Second People's Hospital, Kunming 650021, China;

Corresponding author：

Li Juanjuan, Email: ljj800502@163.com

Keywords：

Angioid streaks/diagnosis; Choroidal neovasculariztion; Tomography, optical coherence; Fluorescein angiography

DOI：

10.3760/cma.j.cn511434-20190409-00131

Video：

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Objective To analyze the OCT angiography (OCTA) features of eyes affected with angioid streaks.Methods Retrospective analysis of 26 patients (52 eyes) diagnosed as angioid streaks by multi-modal imaging in Ophthalmology Department of Yunnan Second People’s Hospital from May 2017 to February 2019 were included in this study. There were 18 males and 8 females, with the mean age of 50.8±6.9 years. All the patients were binocular. There were 34 eyes in 20 patients with CNV. Among them, 13 eyes had a course of disease within 1 month, 16 eyes had a course of disease over 1 month, and 5 eyes were treated with anti-VEGF drugs. All patients were examined by ultra-wide-angle fundus photography, infrared fundus imaging (IR), spectral-domain OCT, FAF and FFA. At the same time, the Heidelberg OCTA instrument was used for OCTA examination. The central wavelength was 840 nm, the acquisition speed was 85,000 times/s, and the width was 45 nm. A 3 mm × 3 mm scan was obtained. Each cube consisted of two 304 B scans of repeated volumes, and motion correction was performed using two orthogonally captured image volume registration. The results of fundus color photography, IR, FAF, FFA, OCT and OCTA were compared and analyzed to summarize the image features of AS and its secondary CNV in OCTA.dus color photography, IR, FAF, FFA, OCT and OCTA were compared and analyzed to summarize the image features of AS and its secondary CNV in OCTA.Results Among 52 eyes, 40 eyes showed choroidal capillary shadows in OCTA, and no obvious abnormal OCTA images in 12 eyes. Ten eyes OCTA showed a vascular network beseide the optic disc, FFA showed fluorescent staining instead of fluorescein leakage. Among the 52 eyes, 34 eyes had secondary macular CNV, and 34 eyes had different forms of CNV. Different forms had a certain correlation with the length of medical history and treatment history. Among them, 13 eyes with short course of disease (less than 1 month) and untreated patients had smaller flower-ring morphology, 16 eyes with longer course (more than 1 month) but no treatment had larger fan-shaped segments, and 5 eyes with anti-VEGF therapy were trimmed after the dendritic shape.Conclusions AS streaks appeared no blood flow signal area in OCTA, and repairing vascular network beside the optic disc can be observed in some AS patients. The CNV performance with different disease course and treatment experience is different.

Citation： Li Hua, Zhang Juan, Zhang Liwei, Jiao Kangwei, Li Juanjuan. Optical coherence tomography angiography features of angioid streaks. Chinese Journal of Ocular Fundus Diseases, 2020, 36(5): 337-342. doi: 10.3760/cma.j.cn511434-20190409-00131 Copy

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8.	Ellabban AA, Tsujikawa A, Matsumoto A, et al. Macular choroidal thickness and volume in eyes with angioid streaks measured by swept source optical coherence tomography[J]. Am J Ophthalmol, 2012, 153(8): 1133-1143. DOI: 10.1097/IAE.0b013e31826b0bbe.
9.	Andreanos KD, Rotsos T, Koutsandrea C, et al. Detection of nonexudative choroidal neovascularization secondary to angioid streaks using optical coherence tomography angiography[J]. Eur J Ophthalmol, 2017, 27(5): 140-143. DOI: 10.5301/ejo.5000995.
10.	Schoenberger SD, Agarwal A. Geographic chorioretinal atrophy in pseudoxanthoma elasticum[J]. Am J Ophthalmol, 2013, 156(4): 715-723. DOI: 10.1016/j.ajo.2013.05.034.
11.	Gliem M, Finger RP, Fimmers R, et al. Treatment of choroidal neovascularization due to angioid streaks: a comprehensive review[J]. Retina, 2013, 33(9): 1300-1314. DOI: 10.1097/IAE.0000000000002327.
12.	Corbelli E, Carnevali A, Marchese A, et al. Optical coherence tomography angiography features of angioid streaks[J]. Retina, 2018, 38(11): 2128-2136. DOI: 10.1097/IAE.0000000000001859.
13.	Chapron T, Mimoun G, Miere A, et al. Optical coherence tomography angiography features of choroidal neovascularization secondary to angioid streaks[J]. Eye (Lond), 2019, 33(3): 385-391. DOI: 10.1038/s41433-018-0213-1.
14.	Gal-Or O, Balaratnasingam C, Freund KB, et al. Optical coherence tomography angiography findings of choroidal neovascularization in pseudoxanthoma elasticum[J]. Int J Retina Vitreous, 2015, 1(1): 11. DOI: 10.1186/s40942-015-0011-x.

1. Spaide RF. Peau d'orange and angioid streaks: manifestations of Bruch membrane pathology[J]. Retina, 2015, 35(3): 392-397. DOI: 10.1097/IAE.0000000000000420.
2. Giacomelli G, Finocchio L, Biagini I, et al. Long-term follow-up of choroidal neovascularization due to angioid streaks with pro re nata intravitreal anti-vegf treatment[J]. Ophthalmologica, 2017, 238(1-2): 44-51. DOI: 10.1159/000477498.
3. Mentes J, Karaca I, Sermet F. Multimodal imaging characteristics of quiescent type 1 neovascularization in an eye with angioid streaks[J]. Am J Ophthalmol Case Rep, 2018, 10: 132-136. DOI: 10.1016/j.ajoc.2018.02.014.
4. Al-Rashaed S, Arevalo JF. Long-term follow-up of choroidal neovascularization secondary to angioid streaks: case series and literature review[J]. Clin Ophthalmol, 2012, 6(1): 1029-1034. DOI: 10.2147/OPTH.S30550.
5. Pece A, Allegrini D, Kontadakis S, et al. Intravitreal ranibizumab for choroidal neovascularization in a patient with angioid streaks and multiple evanescent white dots[J/OL]. BMC Ophthalmol, 2016, 16: 122[2016-07-26]. https://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-016-0307-0. DOI: 10.1186/s12886-016-0307-0.
6. Tetikoglu M, Sagdik HM, Aktas S, et al. Intravitreal aflibercept for refractory choroidal neovascularization secondary to angioid streaks[J]. Eye (Lond), 2016, 30(6): 894-895. DOI: 10.1038/eye.2016.28.
7. Nakagawa S, Yamashiro K, Tsujikawa A, et al. The time course changes of choroidal neovascularization in angioid streaks[J]. Retina, 2013, 33(4): 825-833. DOI: 10.1097/IAE.0b013e31826b0bbe.
8. Ellabban AA, Tsujikawa A, Matsumoto A, et al. Macular choroidal thickness and volume in eyes with angioid streaks measured by swept source optical coherence tomography[J]. Am J Ophthalmol, 2012, 153(8): 1133-1143. DOI: 10.1097/IAE.0b013e31826b0bbe.
9. Andreanos KD, Rotsos T, Koutsandrea C, et al. Detection of nonexudative choroidal neovascularization secondary to angioid streaks using optical coherence tomography angiography[J]. Eur J Ophthalmol, 2017, 27(5): 140-143. DOI: 10.5301/ejo.5000995.
10. Schoenberger SD, Agarwal A. Geographic chorioretinal atrophy in pseudoxanthoma elasticum[J]. Am J Ophthalmol, 2013, 156(4): 715-723. DOI: 10.1016/j.ajo.2013.05.034.
11. Gliem M, Finger RP, Fimmers R, et al. Treatment of choroidal neovascularization due to angioid streaks: a comprehensive review[J]. Retina, 2013, 33(9): 1300-1314. DOI: 10.1097/IAE.0000000000002327.
12. Corbelli E, Carnevali A, Marchese A, et al. Optical coherence tomography angiography features of angioid streaks[J]. Retina, 2018, 38(11): 2128-2136. DOI: 10.1097/IAE.0000000000001859.
13. Chapron T, Mimoun G, Miere A, et al. Optical coherence tomography angiography features of choroidal neovascularization secondary to angioid streaks[J]. Eye (Lond), 2019, 33(3): 385-391. DOI: 10.1038/s41433-018-0213-1.
14. Gal-Or O, Balaratnasingam C, Freund KB, et al. Optical coherence tomography angiography findings of choroidal neovascularization in pseudoxanthoma elasticum[J]. Int J Retina Vitreous, 2015, 1(1): 11. DOI: 10.1186/s40942-015-0011-x.

Chinese Journal of Ocular Fundus Diseases

Optical coherence tomography angiography features of angioid streaks

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