Long-term follow-up of choroidal neovascularization secondary to angioid streaks: case series and literature review

Background: The purpose of this paper is to report the clinical course of choroidal-neovascularization (CNV) secondary to angioid streaks and the outcomes in response to different treatment modalities. Methods: This was a case series of two consecutive patients (four eyes) with CNV secondary to angioid streaks. Visual acuity, ophthalmological examination, color photographs, fluorescein angiography, and optical coherence tomography were used to assess the outcomes of treatment. Results: Two eyes were treated with photodynamic therapy for subfoveal choroidal neovascular membrane, one eye underwent thermal laser photocoagulation for extrafoveal CNV followed by intravitreal bevacizumab for subfoveal CNV, and one eye underwent intravitreal bevacizumab for subfoveal CNV. The follow-up period was 4-6 years. The final visual acuities of all eyes were 20/300 or worse with large submacular fibrosis. Conclusion: CNV secondary to angioid streaks in these two patients had a poor prognosis despite undergoing different types of treatment. Poor outcome was likely related to frequent recurrence and newly developed CNV, which remained a clinical concern in these cases.