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Sickle cell retinopathy associated with retinal thinning
WAILEA, Hawaii – Spectral domain optical coherence tomography may be used to gauge retinal anatomic changes in eyes with sickle cell retinopathy, a speaker said here.
Jennifer I. Lim
“If you feel you have a sickle cell patient and you want to determine how severe it is, one of the things that is useful is to look at the OCT and see if there is retinal thinning present,”Jennifer I. Lim, MD, said at Retina 2015. “Sixty percent of your sickle cell patients are going to have this, and most of the time they’re going to be asymptomatic and you don’t need to be too concerned about it.”
Patients with sickle cell retinopathy should be monitored regularly for anatomic changes and vision loss, Lim said.
In a study including 128 eyes of 64 sickle cell anemia patients and 24 eyes of 12 age- and race-matched controls, Lim reported that focal retinal thinning was identified in 36 sickle cell eyes (56%) and no control eyes.
Visual acuity in sickle cell eyes with focal macular thinning ranged from 20/15 to 20/200. Most eyes had 20/20 vision and were asymptomatic.
“Your patient may be seeing perfectly well but they may already have affected parts of their retina,” Lim said.
Central macular thickness was 220 μm in sickle cell patients and 240 μm in controls; the difference was statistically significant (
In another phase of the study, optic nerve and retinal nerve fiber layer (RNFL) thickness was measured in 151 eyes of 88 sickle cell patients and 55 eyes of 30 controls. Results showed that sickle cell retinopathy eyes with macular thinning had thinner mean peripapillary RNFL in the nasal and superotemporal sectors than controls.
Choroidal thinning may also be associated with sickle cell disease, Lim said. – by Matt Hasson and Patricia Nale
Disclosure: Lim reports no relevant financial disclosures.