Angioid streaks are breaks in the layer underlying the retina, called Bruch’s membrane. Certain conditions that lead to brittleness of Bruch’s can develop to these linear cracks, mostly around the optic nerve and posterior aspects of the globe. Bruch’s membrane serves as a physical barrier between the retina and the underlying blood vessels of the choroid, while allowing the diffusion of oxygen and small molecules to nourish the outer retina. I often explain to my patients that Bruch’s membrane is like a layer of concrete on the pavement, that when cracked allows the underlying grass and vegetation to come through it. In the case of the eye, instead of blades of grass, it is blood vessels that creep through the fissures, creating subretinal choroidal neovascularizations. The patient in this post has a condition called pseudoxanthoma elasticum and has abundant angioid streaks in both eyes. Unfortunately, the patient developed choroidal neovascularization under both maculas, and has fibrotic scars with severe central vision loss in both eyes. The angioid streaks are more noticeable under autofluorescent imaging, where I have attempted to highlight them in yellow. The skin in the back of the neck of the patient has the classic “peau d’orange” changes of pseudoxanthoma elasticum. -- It has been four months since our new practice, Deep Blue Retina opened its doors. I am so thankful for my patients and the community for their support. We have been getting busier every week, but we are making every effort to maintain the personal connection that our patients require. We have been refining the work of our imaging department (which shows in the quality of the photography that we can present in this medium). Our electrophysiology and ultrasonography department is building its technical expertise. The team is growing, and we will announce the additions to our programs in the coming weeks. #goodthingstocome #lookingforwardto2020 #ophthalmology #retina #optometry #clinicalresearch #medicaleducation (at Memphis Tennese) https://www.instagram.com/p/B4snF4LhmKy/?igshid=qkazgvowfh1p
