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Progressive Retinal Thinning in Sickle Cell Retinopathy
Cindy X Cai1, Ian C Han2, Jing Tian3
1Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.
Ophthalmology. Retina
|May 4, 2019
Summary
Patients with sickle cell experience progressive retinal thinning, particularly in the superficial and middle retinal layers. This may indicate ongoing microvascular damage in the eyes of sickle cell patients.
Area of Science:
- Ophthalmology
- Hematology
- Medical Imaging
Background:
- Sickle cell disease is a genetic blood disorder.
- Retinal changes are a known complication of sickle cell disease.
- Spectral-domain optical coherence tomography (SD-OCT) is a key imaging modality for retinal assessment.
Purpose of the Study:
- To quantify the rate of retinal thinning in patients with sickle cell disease compared to healthy controls.
- To analyze retinal thickness changes across different retinal layers using SD-OCT.
Main Methods:
- A retrospective, longitudinal study comparing patients with sickle cell disease and age-similar controls.
- SD-OCT macula volume scans were analyzed using automated segmentation to divide the retina into superficial, middle, and outer layers.
- The rate of change in retinal thickness was calculated over time using a multilevel mixed-effects model.
Main Results:
- Patients with sickle cell disease showed thinner initial retinal thickness compared to controls in all analyzed layers.
- A significantly greater rate of retinal thinning was observed in the sickle cell group, especially in the superficial and middle retina.
- Progressive thinning was noted in the superficial retina (center, nasal, temporal) and middle retina (temporal) of sickle cell patients.
Conclusions:
- Patients with sickle cell disease exhibit progressive retinal thinning, predominantly in the superficial and middle retinal layers.
- This progressive thinning may be a consequence of chronic microvascular damage associated with sickle cell disease.
- SD-OCT is valuable for monitoring retinal structural changes in sickle cell patients.
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