A Case Report of Choroidal Neovascularization Secondary to Angioid Streaks Associated With Beta Thalassemia

A 58-year-old Malay male with underlying beta thalassemia presented with distorted vision in the right eye for two weeks. On presentation, his visual acuity (VA) was 6/18 OD (right eye) and 6/9 OS (left eye). Fundus examination of the right eye revealed a pink optic disc with peripapillary atrophy and numerous narrow, irregular streaks radiating in a circumferential pattern, along with macular scarring and pigment deposition. The patient was ametropic, with a right eye axial length of 24.72 mm. Optical coherence tomography (OCT) of the macula of the right eye showed subretinal and intraretinal cystic fluid with subretinal fibrosis. Fundus fluorescein angiography demonstrated leakage at 44 seconds, increasing in intensity and size in the early venous phase. The patient was diagnosed with choroidal neovascularization (CNV) secondary to angioid streaks. He was treated with intravitreal ranibizumab, receiving a monthly loading dose for three months, followed by a treat-and-extend regimen up to 16-week intervals. The patient's symptoms resolved after the first injection, and follow-up OCT showed sustained resolution of fluid. Final VA remained 6/18 OD and 6/9 OS, with symptomatic improvement and stability of the condition.