OCT Tip 227 was originally published on Dec 10th, 2021.

A patient presents with new floaters. What might be the cause?

Tip #227


This is an image showing the optic disc. Overlying the disc there is evidence of scattered hyper reflectivity indicating material in the posterior vitreous. Dilated examination showed some perivascular sheathing (video) and peripheral non-perfusion. In addition, there is a small elevated area of the RPE. This corresponded to a linear area of RPE hyperplasia. An angiogram confirmed the presence of angioid streaks.

The patient was treated for both vasculitis and angioid streaks.

In this tip's accompanying 17 min. video, we'll review:

  • Learn how angioid streaks presents and its risk
  • The systemic diseases associated with angioid streaks
  • The systemic evaluation of vasculitis
Tip #227 Analysis


In a patient with RPE alteration, especially when associated with circumferential changes around or radiating from the disc, think of angioid streaks.

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