Epidemiology of Angioid Streaks-Associated Choroidal Neovascular Membranes in the United Kingdom

Background: The purpose of this study is to determine the incidence of angioid streak-associated choroidal neovascular membranes (CNV) in the UK and provide other epidemiological data, clinical characteristics, therapies used, and short-term outcomes following treatment of this condition. Procedure: This is a prospective multicenter cohort study. Patients newly diagnosed of angioid streaksassociated CNV were identified prospectively over a 14-month period (January 2009-March 2010) by active surveillance through the British Ophthalmic Surveillance Unit (BOSU). Questionnaire-based data was obtained from reporting ophthalmologists at baseline and 12 months. The main outcome measure was incidence of angioid-streak associated CNV. Secondary outcomes included clinical characteristics, treatments used, and visual outcomes. Results: Forty-four cases of angioid streak-associated CNV were reported to BOSU, giving an annual incidence of 0.057 (95% CI: 0.040-0.074) per 100,000 population. Affected patients had a mean age of 47 years (range: 24-62 years), presented with a mean (SD) LogMAR visual acuity (VA) of 0.53 (0.51) (Snellen equivalent 6/18), and had most often subfoveal CNV. At one year, the mean LogMAR visual acuity had declined to 0.73 (0.59) (Snellen equivalent 6/36). Visual acuity improved > two Snellen lines in six cases (21%) and deteriorated > two lines in 13 cases (41%). Treatments used included anti-VEGF in 25 eyes (83%), photodynamic therapy (PDT) in two (7%), and observation in three (10%). Conclusions: This study represents the first population-based prospective study evaluating the incidence of angioid streak-associated CNV in the UK. Despite new treatments for CNV, the visual outcome of patients with this disorder remains guarded. Categories: Ophthalmology