Knapp Striae!

𝘈𝘯𝘨𝘪𝘰𝘪𝘥 𝘚𝘵𝘳𝘦𝘢𝘬𝘴⁣⁣⁣ ⁣⁣⁣ ● Bilateral⁣⁣⁣ ● Irregular linear breaks in the degenerated Bruch’s membrane⁣⁣⁣ ● Radiate from the optic disc in a cruciate pattern from an area of peripapillary pigment alteration⁣⁣⁣ ● Taper as they go away from the disc⁣⁣⁣ ● Pull of extraocular muscles create stress forces against the fixed point of the optic nerve which results in this pattern⁣⁣⁣ ● Colour varies from red to dark brown depending on the colour of fundus and overlying RPE atrophy⁣⁣⁣ ● Asymptomatic unless they involve macula⁣⁣⁣

⁣⁣⁣ 𝐀𝐬𝐬𝐨𝐜𝐢𝐚𝐭𝐞𝐝 𝐟𝐮𝐧𝐝𝐮𝐬 𝐜𝐡𝐚𝐧𝐠𝐞𝐬:⁣⁣⁣ ⁣⁣⁣ ● Peau d’orange appearance - diffuse mottling of RPE representing focal defects in Bruch’s membrane and choriocapillaries⁣⁣⁣ ● Salmon spots - peripheral punched out focal yellowish atrophic RPE spots⁣⁣⁣ ● Optic disc drusen⁣⁣⁣ ● Fresh hemorrhages⁣⁣⁣ ● Cracked egg shell appearance - diffuse angioid streaks⁣⁣⁣ ⁣⁣⁣ 𝐒𝐲𝐬𝐭𝐞𝐦𝐢𝐜 𝐀𝐬𝐬𝐨𝐜𝐢𝐚𝐭𝐢𝐨𝐧𝐬: ⁣⁣⁣ ⁣⁣⁣ 𝘗𝘌𝘗𝘚𝘐 Mnemonic:⁣⁣⁣ ● Pseudoxanthoma Elasticum⁣⁣⁣ ● Ehler- Danlos Syndrome⁣⁣⁣ ● Paget’s Disease⁣⁣⁣ ● Sickle Cell Anemia⁣⁣⁣ ● Idiopathic (50%)⁣⁣⁣ ⁣⁣⁣ ⁣ 𝐇𝐢𝐬𝐭𝐨𝐩𝐚𝐭𝐡𝐨𝐥𝐨𝐠𝐲:⁣⁣⁣ ⁣⁣⁣ ● Extensive calcification and thickening of Bruch’s membrane and the intervening interstitial spaces between capillaries⁣⁣⁣ ● Elastic lamina affected⁣⁣⁣ ● Basophilic staining due to deposition of calcium seen with H&E⁣⁣⁣ ⁣⁣⁣ 𝐂𝐨𝐦𝐩𝐥𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬:⁣⁣⁣ ⁣⁣ ● Choroidal neovascularisation⁣⁣⁣ ● Macular degeneration⁣⁣⁣ ● Traumatic membrane rupture⁣⁣⁣ ● RPE tears⁣⁣⁣ ⁣⁣⁣ 𝐅𝐅𝐀: Window defect - Early hyperfluorescence with late staining⁣⁣⁣ ⁣⁣⁣ www.ophthalmobytes.com⁣⁣⁣ ⁣⁣⁣ Image from Rajan Eye Care Hospital⁣⁣⁣ #ophthalmology #ophthal #retina #angioidstreaks #choroidalneovascularisation #cnvm #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmologyresident #ophthalmologyresidency