| Siegrist streaks | |
|---|---|
| Differential diagnosis | hypertensive choroidopathy |
Siegrist streaks are a rare manifestation of hypertensive choroidopathy. They are described as hyper-pigmented flecks that are arranged in a linear fashion along the choroidal vessels of the eye.
Hypertension, also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure typically does not cause symptoms. Long-term high blood pressure, however, is a major risk factor for coronary artery disease, stroke, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia.
Hyperpigmentation is the darkening of an area of skin or nails caused by increased melanin.
The choroid, also known as the choroidea or choroid coat, is the vascular layer of the eye, containing connective tissues, and lying between the retina and the sclera. The human choroid is thickest at the far extreme rear of the eye, while in the outlying areas it narrows to 0.1 mm. The choroid provides oxygen and nourishment to the outer layers of the retina. Along with the ciliary body and iris, the choroid forms the uveal tract.
Although they are usually indicative of fibrinoid necrosis associated with malignant hypertension, Siegrist streaks also occur in patients with temporal arteritis. They are named after Swiss ophthalmologist, August Siegrist (1865–1947).
Fibrinoid necrosis is a specific pattern of irreversible, uncontrolled cell death that occurs when antigen-antibody complexes are deposited in the walls of blood vessels along with fibrin. It is common in the immune-mediated vasculitides which are a result of type III hypersensitivity. When stained with hematoxylin and eosin, they appear brightly eosinophilic and smudged.
August Siegrist was a Swiss ophthalmologist remembered for describing Siegrist streaks. He trained at Basel, Zurich, Lausanne, Vienna and Bern, where he received his M.D. in 1892. He studied further in Bern under Emil Theodor Kocher and in Vienna under Ernst Fuchs. He was habilitated in ophthalmology at Basel in 1900, and in 1903 succeeded Ernst Pflüger as professor of ophthalmology and director of the eye clinic at the University of Bern. He maintained these positions at Bern up until 1935. He worked on the correction of keratoconus including the use of early contact lenses.
