Ocular findings in homozygous sickle cell disease in Jos, Nigeria

Ophthalmological examinations were performed in 78 homozygous sickle cell (Hb SS) patients, aged 4-42 years attending the sickle cell clinic of the Jos University Teaching Hospital, and the University Clinic, Jos, in Nigeria. Conjunctival signs present in about 77% of cases were observed in all ages and sexes. White without pressure present in 62.8% of the cases was the commonest retinal sign and in 56.3% of the cases was associated with peripheral retinal vessel disease. Salmon patches (6.4%), iridescent spots (10.3%), mottled brown areas (16.7%) and black sunbursts (7.7%) were seen as early as 10 years of age but showed an upward trend with age. Peripheral retinal vessel disease present in 52.5% of the cases was the second commonest retinal sign and with the exception of arteriolar occlusion showed no sex predilection, but an upward trend with age. Arterio-venous anastomosis (7.7%), vitreous haemorrhages and veils (3.8%) were the only severe proliferative signs noted. There were no cases of retinal neovascularization, retinal detachment or of angoid streaks, and the posterior poles were normal. Retinal signs were present as early as 8 years of age and showed an upward trend with age.