Ischemic maculopathy with temporal macular thinning on spectral‐domain optical coherence tomography in sickle cell retinopathy: about three cases

Abstract

Purpose Ischemic maculopathy with temporal macular thinning was recently described on OCT in patients with sickle cell disease. In the current study, we describe the features on Spectral Domain OCT(SD‐OCT)in three patients. Methods We report 3 cases of sickle cell patients presenting ischemic maculopathy documented by ophthalmologic clinical evaluation, fluorescein angiography (FA),and SD‐OCT. Results The three patients present stage 3 sickle cell peripheral ischemic retinopathy (Goldberg classification) and bilateral enlargement of ACV in FA. The first patient is a 35 year old man. SD‐OCT shows bilateral thinning in temporal macula retina. Thickness measurement is respectively in right and left eye, 271µm and 219 µm in foveolar region, 275µm and 302µm in temporal perifoveolar region, 203µm and 265 µm in temporal parafoveolar region. The second patient is aged 15. Angiograms reveal a small arteriolar occlusion in the right temporal macula. On SD‐OCT retinal thickness measurement is decreased in both temporal macula: 240µm and 261µm in foveolar region, 233µm and 265µm in temporal perifoveolar region vs 276µm and 358µm in nasal perifoveolar region, 199µm and 230 µm in temporal parafoveolar region vs 292µm and 319µm in nasal parafoveolar region (respectively in right and left eye). The third patient is aged 19 and present the same OCT aspect. Temporal retinal thinning is predominant in inner layers in the three patients. Conclusion Sickle cell retinopathy can affect macular area through the same process of peripheral terminal vascular occlusion. SD‐OCT provides high resolution images that shows temporal macular thinning which is predominant in the retinal inner layers.