A 30 year old female found to have ‘angioid streaks’ on retina during ocular examination. Which of the following systemic illness is associated with this clinical presentation?
**Core Concept**
Angioid streaks are a specific type of retinal degeneration characterized by breaks in the Bruch's membrane, leading to the formation of irregular, linear, and often branching retinal vessels. This condition is often associated with systemic diseases that cause alterations in the elastic tissue and collagen.
**Why the Correct Answer is Right**
The correct answer is associated with pseudoxanthoma elasticum (PXE), a genetic disorder affecting the elastic tissue in the skin, eyes, and cardiovascular system. The angioid streaks in PXE result from the fragmentation and calcification of elastic fibers in the Bruch's membrane, leading to retinal degeneration and vision loss. This condition is often inherited in an autosomal recessive pattern and can be caused by mutations in the ABCC6 gene.
**Why Each Wrong Option is Incorrect**
**Option A:**
This option is incorrect because systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can cause retinal vasculitis, but it is not typically associated with angioid streaks.
**Option B:**
This option is incorrect because diabetes mellitus is a metabolic disorder that can cause diabetic retinopathy, but it does not typically cause angioid streaks.
**Option C:**
This option is incorrect because hypertension is a cardiovascular disease that can cause hypertensive retinopathy, but it is not typically associated with angioid streaks.
**Option D:**
This option is incorrect because multiple sclerosis is a neurological disease that can cause optic neuritis, but it is not typically associated with angioid streaks.
**Clinical Pearl / High-Yield Fact**
PXE is a systemic disease that requires a comprehensive evaluation of the skin, eyes, and cardiovascular system, as it can lead to complications such as retinal detachment, macular degeneration, and cardiovascular disease.
**Correct Answer:** D.