Sickle cell retinopathy: improving care with a multidisciplinary approach

Area of Science:

• Ophthalmology
• Hematology
• Genetics

Background:

• Sickle cell retinopathy (SCR) is a major complication of sickle cell disease (SCD), potentially causing irreversible vision loss.
• Recent research has identified systemic, genetic, and ocular risk factors for SCR, improving diagnosis and management.
• Advanced imaging like spectral domain-optical coherence tomography angiography detects subclinical SCR.

Purpose of the Study:

• To present advances and recommendations in SCR theranostics based on a decade of research.
• To highlight the need for combinatorial treatment approaches for SCR patients.
• To review developments in diagnosing and managing SCR complications in sickle cell disease.

Main Methods:

• Retrospective analysis of studies from 2007-2017.
• Inclusion of randomized controlled trials, reviews, clinical trials, and observational studies.
• Systematic literature search using specified keywords across major databases (Medline, Embase, Cochrane, ClinicalTrials.gov).

Main Results:

• Intravitreal anti-VEGF injections (ranibizumab, aflibercept) show safety and efficacy, often combined with laser photocoagulation (LPC) for proliferative SCR.
• LPC alone has limited effect on advanced SCR regression but helps prevent hemorrhage and vision loss.
• Newer imaging modalities enhance the detection of early-stage SCR.

Conclusions:

• Multidisciplinary research has improved SCR diagnosis and management strategies.
• Combinatorial therapeutic approaches, including anti-VEGF and LPC, are crucial for optimal SCR patient care.
• Continued research is essential to further refine SCR theranostics and improve patient vision outcomes.