Angioid streaks. II. Fluorescein angiographic features.

Fluorescein angiographic sequences from 31 patients with angioid streaks were evaluated. In contrast to previous reports, the streaks usually showed an early central zone of hypofluorescence. We postulated that the hypofluorescence was due to a break in Bruch membrane, causing a separation of the choriocapillaris. This resulted in an area of nonperfusion. Adjacent light-colored areas were hyperfluorescent, possibly due to abnormal retinal pigment epithelium, thickened Bruch membrane, and patent choriocapillaris. The hypofluorescence of the paired red-brown spots may have resulted from an increased pigment density. The intermittent hypofluorescent spots comprising the area of peau d'orange were thought due to focal dehiscences in Bruch membrane and the choriocapillaris. The hyperfluorescent isolated focal lesions may have resulted from an abnormal thickening of Bruch membrane and a patent choriocapillaris.