Paget s Disease with Angioid Streaks of the Retina: Case Report

Case Report

Austin Ophthalmol. 2023; 7(1): 1044.

Paget’s Disease with Angioid Streaks of the Retina: Case Report

Homaide S1,2*; Boussetta S1,2; Cheikh Z1,2; Mchachi A1,2; Benhmidoune L1,2; Rachid R1,2; Elbelhadji M1,2

¹Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Morocco

²Department of Ophthalmology, Hospital 20 August 1953, CHU Ibn Rochd, Morocco

*Corresponding author: Soukaina Homaide Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca Morocco. Email: salma_moataz@hotmail.fr

Received: March 06, 2023 Accepted: April 10, 2023 Published: April 17, 2023

Abstract

Angioid streaks are a striking fundus change produced by linear breaks in Bruch’s membrane. First described in 1889 by Doyne in a patient with retinal hemorrhages secondary to trauma. They are most often associated with pseudoxanthoma elasticum, but there have been a number of cases reported in connection with other conditions, such as Paget’s disease, which is a localized disorder of bone remodeling characterized by the increase in bone resorption followed by an increase in new bone formation, altering bone architecture. Angioid streaks are present in 10 to 15% of patients with Paget’s disease. It was aimed to share this case report to underline the rarity of this combination.

Keywords: Angioid streaks; Paget’s disease; Choroidal neovascularization

Introduction

Angioid streaks are often associated with a systemic condition, most frequently pseudoxanthoma elasticum, Paget’s disease and sickle-cell anemia. They are described as visible, linear, irregular, cracklike dehiscences of Bruch membrane, which may be unilateral or most commonly bilateral. Several diagnostic methods are useful to diagnose, evaluate, and monitor angioid streaks, and various treatment modalities have been used, with promising results.

The purpose of this case report is to review the literature on angioid streaks, and to highlight pathophysiology, clinical presentation, imaging, and treatment modalities for angioid streaks.

Case Report

F.A. a woman aged 41, She was small with the typical bowing of the legs and enlargement of the head characteristic of Paget's disease (Figure 1). She had no ocular complaints. She came for a routine eye examination. The ocular findings were as follows: Best-corrected visual acuity was 20/20 bilaterally. External ocular examination was normal. Examination of the fundus in both eyes showed an irregular halo of choroidal depigmentation surrounding the nerve head, with brownish linear irregularities extending radially from the peripapillary region into the peripheral fundus a finding consistent with the presence of angioid streaks (Figure 2). In autofluorescence, they appeared hypoautofluorescent (Figure 3). Simple observation was our treatment option since there was no complication such as choroidal neovascularization.