[Contribution of indocyanine green angiography in sickle cell retinopathy]
J W Diallo1, D Kuhn, P Haymann-Gawrilow
1Centre Hospitalier Universitaire, Souro Sanou, Bobo Dioulasso, Burkina Faso. diallojeanw@yahoo.fr
Purpose Of The Study:
This was a prospective, nonrandomized observational study to search for choroidal abnormalities associated with sickle cell retinopathy and to assess the contribution of indocyanine green angiography (ICG) in this disease.
Patients And Method:
From July to October 2000, 26 patients with sickle cell disease (SS, SC, and thalassemia) were recruited, most followed in the pediatric department. After an ophthalmologic clinical examination, fluorescein angiography and indocyanine green angiography(ICG) were performed.
Results:
The average age was 14.3 years (range, 9-24 years). There were 17 SS forms (65.4%), five SC forms (19.2%), and four beta-thalassemia forms (15.4%). The ICG was well tolerated. In 24 cases (92.3%), we observed rarefaction of the choriocapillaris out of the posterior pole with no difference depending on the genotype. We noted neither hypo- nor hyperfluorescence of the choroid at the retinal ischemic areas, the black spots were clearly delimited, and photocoagulation scars appeared larger than in fluorescein angiography.
Discussion:
Our ICG study did not show anomalies of the choroidal circulation but rarefaction of the choriocapillaris was observed in most patients, a striking finding. This lower visibility or nonperfusion could be explained by anatomical modifications or by a centripetal reduction in the density of the choriocapillaris concomitant to the microvascular occlusive phenomena in the ischemic retina.
Conclusion:
This study is the first to use ICG in sickle cell retinopathy. The rarefaction of the choriocapillaris observed may be related to the systemic disease. However, it must be compared with the choriocapillaris of normal subjects at the same age.
