title: Treatment of choroidal neovascularization due to angioid streaks: a comprehensive review.
abstract: OBJECTIVE
  To evaluate different therapies for choroidal neovascularization (CNV) due to angioid streaks (AS).
  
  
  METHODS
  Studies were identified by a systematic literature search and were included in the analysis based on predefined criteria. Primary outcome measure was change in best-corrected visual acuity (BCVA).
  
  
  RESULTS
  Fifty-four relevant studies were identified and included mostly uncontrolled case series. No randomized controlled trials were available. Treatment with vascular endothelial growth factor inhibitors improved or stabilized BCVA in all case series. Photodynamic therapy slowed down disease progression with stabilization or decrease of BCVA. Individual BCVA and follow-up data for each treated eye were reported in >160 cases for both treatments, vascular endothelial growth factor inhibitors and photodynamic therapy. In a pooled analysis of those studies, the difference of mean change in BCVA between both treatment groups was estimated as approximately 6 lines (0.59 logMAR [95% confidence interval, 0.38-0.8; P < 0.0001]). A better baseline BCVA was associated with a better BCVA outcome (P < 0.0001). Laser photocoagulation yielded comparable results as photodynamic therapy but application was mostly restricted to extrafoveal lesions, was complicated by frequent recurrences, and led to more retinal damage with subsequent absolute scotomas. Combination therapies seem to be not superior to monotherapy.
  
  
  CONCLUSIONS
  Intravitreal vascular endothelial growth factor inhibitors are currently the most effective treatment of CNV due to angioid streaks.
authors.affiliation: Department of Ophthalmology, University of Bonn, Bonn, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Gliem
authors.forename: Robert P
authors.initials: RP
authors.lastname: Finger
authors.forename: Rolf
authors.initials: R
authors.lastname: Fimmers
authors.forename: Christian K
authors.initials: CK
authors.lastname: Brinkmann
authors.forename: Frank G
authors.initials: FG
authors.lastname: Holz
authors.forename: Peter
authors.initials: P
authors.lastname: Charbel Issa
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000793:Angioid Streaks / Q000150:complications*; D020256:Choroidal Neovascularization / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008028:Light Coagulation / Q000379:methods; D010778:Photochemotherapy / Q000379:methods; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors