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Presentation type	E-poster
Title	Unilateral diffuse retinal bleeding and explosive choroidal neovascularization after coughing in a patient with angioid streaks

Purpose	Presentation of a peculiar case of a unilateral retinal bleeding and explosive choroidal neovascularization in a patient with angioid streaks, its work-up and its treatment.
Methods	Multimodal imaging (fundus photography, OCT, angio-OCT and fluorescein angiography) was performed to assess a 39-year-old man with angioid streaks who complained of distortion of vision and a decrease in visual acuity in the right eye 2 weeks after an episode of cough. An explanation for the unilateral presentation was assessed by looking for signs of fragility of the right eye compared to the left eye.
Results	Fundus exam: on the right eye, multiple retinal fusiform hemorrhages in all 4 quadrants that were absent on the left eye. OCT: signs of 3 infiltratives zones of perifoveolar suberetinal choroidal neovascularization with serous retinal detachment in the right eye and physiological foveolar depression in the left eye. Angio-OCT: non-contributive. Fluorescein angiography: right eye: multiple perifoveolar staining of neovascular choroidal lesions. Concerning signs of fragility: the right eye is surprisingly less myopic (25.88 mm) and presumed less fragile than the left eye (26.21 mm) and the involvement of the angioid streaks seems similar and symmetric.
Conclusion	Complicated angioid streaks in the right eye with type 2 neovascularization of explosive onset and retinal hemorrhages on Valsalva effort. We performed intravitreal injections of anti-VEGF ranibizumab and planned follow-up consultations. No reason was yet found for the unilaterality of the ocular involvement. A vascular assessment could be considered in order to objectify a potential asymmetry explaining the unilaterality of the ocular involvement.
Conflict of interest	No

Authors 1

Last name	GIELEN
Initials	C
Department	Cliniques Universitaires Saint-Luc
City	Brussels

Authors 2

Last name	Guagnini
Initials	A-P
Department	Cliniques Universitaires Saint-Luc
City	Brussels