Anti-vascular Endothelial Growth Factor Therapy (anti-VEGF) in the Treatment of Neovascular Membrane Secondary to Angioid Streaks – Case Report

Angioid streaks, a rare defect of Bruch’s membrane, are most typically characterized by an asymptomatic course. However, when complications such as submacular hemorrhage or a neovascular membrane develop, visual acuity may deteriorate markedly, requiring therapeutic intervention. Angioid streaks can be associated with a number of systemic diseases, the most common being pseudoxanthoma elasticum, Paget’s disease, Ehlers–Danlos syndrome, beta thalassemia, and sickle cell anemia. This underscores the need for comprehensive systemic evaluation to identify potential comorbid conditions. We present the case of a 29-year-old patient in whom visual deterioration accompanied by image distortion was the first manifestation of angioid streaks complicated by a neovascular membrane. We demonstrate the positive therapeutic effects of intravitreal anti-vascular endothelial growth factor injections with ranibizumab. A total of five injections were required to stabilize the disease process, resulting in full visual acuity and complete resolution of subjective symptoms such as image distortion. Neoangiogenesis is the most common and most serious complication of angioid streaks. The fact that the disorder is rare, and at the same time linked to numerous systemic diseases, continues to hinder the development of standardized treatment protocols. The primary therapeutic method, yielding good results, is intravitreal anti-vascular endothelial growth factor treatment. Inhibition of vascular endothelial growth factor, the main mediator of angiogenesis and vascular permeability, plays a key role in stabilizing the disease. Moreover, early intervention is associated with markedly better outcomes and enables favorable anatomical and functional results.