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Clinicians and pathologists differ widely in their concepts of choroidal angiosclerosis. Most clinicians equate this term with white streaking of the larger choroidal vessels and assume—if I interpret their assumptions properly—microscopic examination to reveal occlusive changes similar to those of arteriosclerosis elsewhere in the body. This clinical manifestation of "choroidal angiosclerosis" is most marked and most regularly seen in tapetoretinal degenerations such as retinitis pigmentosa and macular (areolar) degeneration. Yet histologic examination of the choroidal vessels in these conditions has failed to show the anticipated changes. The fact that the white streaking disappears abruptly as the vessels pass beneath the pigment epithelium and choriocapillaris suggests it may be an artifactual appearance due to loss of the overlying layers.
In contrast to clinicians, most pathologists equate choroidal angiosclerosis with a hyalinization of the intermediate-sized vessels and of the choriocapillaris such as one sees characteristically with malignant hypertension. The pathologists would expect—
C. DG. Two Views of Choroidal Angiosclerosis. Arch Ophthalmol. 1965;73(3):309. doi:10.1001/archopht.1965.00970030311001