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Case Reports
. 2025 May 25;17(5):e84800.
doi: 10.7759/cureus.84800. eCollection 2025 May.

A Case Report of Choroidal Neovascularization Secondary to Angioid Streaks Associated With Beta Thalassemia

Thanam Tamil Chelvan  1 , Teck Chee Cheng  1 , Jemaima Che Hamzah  1 , Ainal Adlin Naffi  1
Affiliations
Case Reports

A Case Report of Choroidal Neovascularization Secondary to Angioid Streaks Associated With Beta Thalassemia

Thanam Tamil Chelvan et al. Cureus. .

Abstract

A 58-year-old Malay male with underlying beta thalassemia presented with distorted vision in the right eye for two weeks. On presentation, his visual acuity (VA) was 6/18 OD (right eye) and 6/9 OS (left eye). Fundus examination of the right eye revealed a pink optic disc with peripapillary atrophy and numerous narrow, irregular streaks radiating in a circumferential pattern, along with macular scarring and pigment deposition. The patient was ametropic, with a right eye axial length of 24.72 mm. Optical coherence tomography (OCT) of the macula of the right eye showed subretinal and intraretinal cystic fluid with subretinal fibrosis. Fundus fluorescein angiography demonstrated leakage at 44 seconds, increasing in intensity and size in the early venous phase. The patient was diagnosed with choroidal neovascularization (CNV) secondary to angioid streaks. He was treated with intravitreal ranibizumab, receiving a monthly loading dose for three months, followed by a treat-and-extend regimen up to 16-week intervals. The patient's symptoms resolved after the first injection, and follow-up OCT showed sustained resolution of fluid. Final VA remained 6/18 OD and 6/9 OS, with symptomatic improvement and stability of the condition.

Keywords: angioid streaks; anti-vascular endothelial growth factor; beta thalassemia; choroidal neovascularization; optical coherence tomography macula.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. (A) A colored fundus photograph of the right eye shows a pink optic disc with angioid streak (white arrow), along with macula scarring and some greyish pigment deposition (yellow arrow). (B) A colored fundus photograph of the left eye shows a pink optic disc with a peripapillary ring of atrophy with numerous narrow, irregular streaks radiating in a circumferential pattern (green arrow). The retinal vessels appear slightly tortuous and dilated (red arrow).
Figure 2
Figure 2. Optical coherence tomography of the right eye macula shows (A) cystic intraretinal fluid (yellow arrow), (B) subretinal fibrosis (red arrow) and disrupted ellipsoid zone (purple arrow), with (C) subretinal fluid (green arrow).
Figure 3
Figure 3. Fundus fluorescein angiography of the right eye shows (A) hyperfluorescence (white arrow) at venous phase (44 seconds), which increases in size and intensity until two minutes and 47 seconds (B).
Figure 4
Figure 4. Indocyanine green angiography revealed a well-demarcated area of hypofluorescence at the macula (white arrow), corresponding to the site of suspected choroidal neovascularization. The lesion remained hypofluorescent from the mid phase (A, 40 seconds) to the late phase (B, 99 seconds).
Figure 5
Figure 5. Optical coherence tomography of the right eye showing complete resolution of the intraretinal and subretinal fluid with subretinal fibrosis (white arrow).
See this image and copyright information in PMC

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