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The past, present and future management of sickle cell retinopathy within an African context
Kwesi Nyan Amissah-Arthur1, Evelyn Mensah2
1Ophthalmology Unit, Department of Surgery, Korle Bu Teaching Hospital, College of Health Sciences, School of Medicine and Dentistry, University of Ghana, Accra, Ghana. kaarthur@doctors.net.uk.
Insights
Sickle cell retinopathy, a leading cause of blindness in young adults, faces management challenges in Africa due to resource constraints. Future research and technology integration are crucial for improved screening and treatment of this condition.
Area of Science:
- Ophthalmology
- Hematology
- Public Health
Background:
- Sickle cell retinopathy is a significant cause of vision loss in the working-age population.
- Historical reports from Africa were key in understanding the retinal manifestations of sickle cell disease.
- Management of sickle cell disease has advanced globally, but challenges persist in resource-limited settings.
Purpose of the Study:
- To review the historical, current, and future management of sickle cell retinopathy in the African context.
- To highlight the challenges in managing sickle cell retinopathy in Sub-Saharan Africa.
- To explore the potential of future research and technology in addressing this condition.
Main Methods:
- Literature review of past and present management strategies.
- Analysis of clinical course and management complexities.
- Discussion of future research directions and technological applications.
Main Results:
- Sickle cell retinopathy presents a varied clinical picture and course.
- Resource limitations in Sub-Saharan Africa impede effective management.
- Improved outcomes are noted in developed countries with better clinical management.
Conclusions:
- Effective management of sickle cell retinopathy in Africa is hindered by resource constraints.
- Large-scale trials in Africa are needed to understand proliferative sickle retinopathy mechanisms.
- Technology integration is vital for early detection and treatment of sickle cell retinopathy.
Abstract:
Sickle cell retinopathy is a potentially blinding condition that affects young people in the working age group. This review looks at the past, present and future management of sickle cell retinopathy within an African context. After Sickle cell disease was first reported in 1910, some reports from Africa were pivotal in describing the retinal changes associated with the disease. It soon became obvious that there was a varied clinical picture and clinical course. Several landmark studies were carried out in Jamaica to help elucidate the complexities of the disease and outline appropriate clinical management. In most of the developed world, the clinical management of sickle cell disease has improved with concurrent improvement in outcomes. Currently resource constraints in most Sub-Saharan African countries where there is a high burden of disease means that the management of sickle cell retinopathy is fraught with numerous challenges. Future large scale trials in Africa shall hopefully help to better elucidate the mechanisms behind proliferative sickle retinopathy and help in the development of new and improved therapeutic pathways. The use of technology can help immensely in the screening of patients with sickle cell to detect early proliferative changes and if necessary treat accordingly.
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