Pseudovascular streaks: signs, symptoms and causes

Description

Pseudovascular streaks appear asymmetrical, jagged, gradually tapered, and radiate from the edge of the retinal papilla to the macula and fundus periphery.

Causes

Often

Pseudoxanthoma elasticum (Pseudoxanthoma elasticum).

Paget's disease of bone.

Hemoglobin disease.

Less common

Ehlers–Danlos syndrome.

Acromegaly disease.

Neurofibromatosis.

Figure: Pseudovascular streaks

Mechanism

Pseudovascular streaks are of small fragile cracks or calcifications in Bruch's membrane. The clear mechanism for abnormalities in Bruch's membrane has not been verified. The following hypothetical factors are put forward:

Degeneration of the elastic fibers of the membrane.

Iron deposition in elastic fibers after secondary mineralization hemolysis.

Dystrophy due to hemocytosis, stasis, and occlusion of small blood vessels

The tearing force between the intraocular and extraocular muscles is thought to be responsible for the tears in Bruch's membrane.

Meaningful

Nearly 50% of patients presenting with pseudovascular streaks have an underlying disease, so, if present, a more thorough examination is needed. A few studies show:

80-87% of the patients with pseudoxanthoma elasticum have pseudovascular streaks.

2 - 15% of patients with Paget's disease have pseudovascular streaks.

0 - 6% of patients with hemoglobinopathy develop a pseudovascular streak.

This is not a typical symptom of acromegaly.