Multimodal ophthalmological evaluation in a case of angioid streaks, with comet tail lesions and extensive traumatic lesions, in a patient with pseudoxanthoma elasticum

Angioid streaks (AS) are distinctive ophthalmologic manifestations indicative of underlying systemic conditions such as pseudoxanthoma elasticum (PXE). This study explores the clinical significance of AS and associated comet-tail lesions, through a case report of a 37-year-old male patient presenting with sudden blurred vision after trauma that underwent ophthalmological evaluation with a multimodal diagnostic approach incorporating fundoscopy (FO), red-free imaging (RFI), autofluorescence angiography (FAF), near-infrared reflectance imaging (NIR), and optical coherence tomography (OCT) that proved instrumental in the investigation, revealing AS, comet-tail lesions, and others findings that subsequently leaded to the diagnosis of PXE. Additionally, it emphasized the importance of early detection of AS for timely management of associated systemic complications of PXE, and the pivotal role of ophthalmologists in facilitating early diagnosis, monitoring and intervention to mitigate the progression of the associated visual impairments when possible.