Surreal illustration of an eye with angioid streaks and choroidal neovascularization, symbolizing vision loss.

Angioid Streaks and Vision Loss: Understanding Long-Term Outcomes

"New research reveals the challenges of managing choroidal neovascularization due to angioid streaks and highlights the importance of proactive eye care."


Angioid streaks (AS) are breaks in Bruch's membrane, the support structure underneath the retina, and often lead to vision loss through the development of choroidal neovascularization (CNV). CNV occurs when new, fragile blood vessels grow beneath the retina, leaking fluid and blood, which can scar the macula and distort vision.

A recent study investigated the long-term effectiveness of treating CNV secondary to AS with antiangiogenic drugs, a common approach to reduce blood vessel growth and leakage. Antiangiogenic drugs have emerged as a primary treatment, often stabilizing vision for a while. The purpose of the research was to evaluate the long-term outcomes (over four years) of patients with CNV due to AS who received antiangiogenic treatment on an as-needed basis (PRN regimen).

The goal is to equip you with a better understanding of AS and CNV, emphasize the importance of regular eye exams, and encourage proactive management of your eye health. While the research highlights challenges, it also underscores the value of available treatments and ongoing monitoring.

The Challenge of Long-Term Management: What the Study Revealed

Surreal illustration of an eye with angioid streaks and choroidal neovascularization, symbolizing vision loss.

The study, a retrospective case series conducted at a single center, reviewed the medical records of seven patients with CNV due to AS. These patients were treated with antiangiogenic drugs using a PRN regimen, meaning they received injections when there were signs of active CNV, rather than on a fixed schedule. Researchers collected data on visual acuity changes, optical coherence tomography (OCT) findings, treatment details, and systemic associations.

Here's a breakdown of the key findings:

  • Visual Acuity: Despite initial improvements, visual acuity at the end of the follow-up period (average of 53.8 months) was similar to baseline.
  • Macular Thickness: Central macular thickness, a measure of swelling in the retina, did not significantly change from baseline to the end of the study.
  • Treatment Frequency: Patients received an average of 6 antiangiogenic injections during the follow-up, with an average time of 3.8 months between injections.
  • Recurrence: All eyes experienced recurrence of the original AS-CNV at some point during the follow-up, with a mean recurrence rate of 3.1 times.
  • Contralateral Eye Involvement: Three of the seven patients (43%) developed CNV in their other eye during the study.
The study highlights that while antiangiogenic drugs can initially improve CNV related to AS, maintaining these gains in the long term can be challenging with a PRN regimen. Recurrences are common, and visual acuity may return to pre-treatment levels despite ongoing treatment.

What This Means for You: Taking a Proactive Approach

If you have angioid streaks, these findings underscore the importance of regular, consistent follow-up with your ophthalmologist. Even if your vision initially improves with treatment, close monitoring is essential to detect and manage recurrences promptly.

The study also suggests that patient awareness and timely self-referral are critical for successful PRN treatment. Be vigilant about monitoring your vision and report any new symptoms, such as decreased vision, distortion, or blind spots, to your doctor immediately.

While this study sheds light on the challenges of long-term management, it also reinforces the value of available treatments. By working closely with your eye care provider and taking a proactive approach to your eye health, you can maximize your chances of preserving your vision and maintaining a good quality of life.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.2147/opth.s118016, Alternate LINK

Title: Long-Term Follow-Up Of Patients With Choroidal Neovascularization Due To Angioid Streaks

Subject: Ophthalmology

Journal: Clinical Ophthalmology

Publisher: Informa UK Limited

Authors: Maria Martinez-Serrano, Abelardo Rodriguez-Reyes, Jose Luis Guerrero-Naranjo, Guillermo Salcedo-Villanueva, Jans Fromow-Guerra, Gerardo García-Aguirre, Virgilio Morales-Canton, Raul Velez-Montoya

Published: 2016-12-01

Everything You Need To Know

1

What are angioid streaks?

Angioid streaks (AS) are breaks in Bruch's membrane, which is the supportive layer under the retina. These breaks compromise the structural integrity of the eye, potentially leading to vision loss. The presence of AS creates a vulnerability that can cause choroidal neovascularization (CNV).

2

Why is choroidal neovascularization (CNV) important?

Choroidal neovascularization (CNV) is significant because it is a leading cause of vision loss in individuals with angioid streaks. CNV involves the abnormal growth of new, fragile blood vessels beneath the retina. These vessels leak fluid and blood, leading to macular scarring and distortion of vision. The study highlights that the treatment of CNV with antiangiogenic drugs aims to stop the growth of these vessels and stabilize vision.

3

Why are antiangiogenic drugs used?

Antiangiogenic drugs are important because they are the primary treatment used to address the vision loss caused by choroidal neovascularization (CNV). They work by reducing the growth and leakage of the abnormal blood vessels. While the research shows that long-term results can be challenging, the drugs initially improve visual acuity. The study investigated how effective this treatment is when administered on an as-needed basis, highlighting both its benefits and limitations.

4

Why are regular eye exams important?

Regular eye exams are crucial if you have angioid streaks, even if your vision seems fine. The study found that recurrence of choroidal neovascularization (CNV) is common, and visual acuity may return to previous levels. Regular monitoring by an ophthalmologist helps detect the recurrence of CNV. Proactive management and early detection are vital to preserving your vision.

5

What did the study examine?

The study investigated the long-term visual outcomes for patients with choroidal neovascularization (CNV) due to angioid streaks (AS) who were treated with antiangiogenic drugs using a PRN (as-needed) regimen over an average of 53.8 months. The research underscored the importance of vigilant follow-up and the challenges of maintaining vision gains over the long term with this treatment approach. This included changes in visual acuity, optical coherence tomography (OCT) findings, treatment details, and systemic associations.

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