Macular Vascular Abnormalities Identified by Optical Coherence Tomographic Angiography in Patients With Sickle Cell Disease

Han, Ian C.; Tadarati, Mongkol; Scott, Adrienne W.

doi:10.1001/jamaophthalmol.2015.2824

Cited by 63 publications

(60 citation statements)

References 13 publications

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“…31 Han et al demonstrated that areas of decreased blood flow in the deep capillary plexus correlated to areas of macular thinning. 20 Furthermore, the presence of discrete areas of macular thinning on OCT-A has been shown to be correlated with the presence of proliferative sickle retinopathy. 16 This has been corroborated by additional studies including a 2016 retrospective, case-controlled analysis that found temporal macular atrophy to have a positive predictive value of 83% and a negative predictive value of 13% for identifying neovascularization and proliferative sickle retinopathy.…”

Section: Discussionmentioning

confidence: 99%

“…16, 19 Finally, OCT-A has been found to provide a more accurate visualization of the macular vasculature than traditional FA. 20, 21 …”

Section: Introductionmentioning

confidence: 99%

“…Additionally, we hypothesized that the macular changes undetectable on clinical exam and observed in adult SCD populations could be observed in pediatric SCD populations by SD-OCT and OCT-A. 13, 15, 20 These pilot data assessed the utility of UWFA, SD-OCT, and OCT-A in screening for pediatric sickle retinopathy.…”

Section: Introductionmentioning

confidence: 99%

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Optical Coherence Tomography Angiography and Ultra-widefield Fluorescein Angiography for Early Detection of Adolescent Sickle Retinopathy

Pahl

Green

Bhatia

et al. 2017

American Journal of Ophthalmology

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Purpose Using standard screening techniques, sickle retinopathy reportedly occurs in 10% of adolescents with sickle cell disease (SCD). We performed a prospective, observational clinical study to determine if ultra-widefield fluorescein angiography (UWFA), spectral-domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCT-A) detect more frequent retinopathy in adolescents with SCD. Design Cross-sectional study. Methods Setting Institutional. Subjects Sixteen adolescents with SCD, ages 10–19 years, (mean age 14.9 years) and 5 age-equivalent controls (mean age 17.4 years). Observation Procedures Examinations including acuity, standard slit-lamp biomicroscopy, UWFA, SD-OCT and OCT-A were performed. Main Outcome Measures Sickle retinopathy defined by biomicroscopic changes, Goldberg stages I–V, Penman scale, flow void on OCT-A, or macular thinning on SD-OCT. Results While 22/32 SCD eyes (68.8%) had retinopathy on biomicroscopy, by UWFA 4/24 (16.7%) SCD eyes had peripheral arterial occlusion (Goldberg I), and 20/24 eyes (83.3%) had peripheral arteriovenous anastomoses (Goldberg II) in addition. No patients had Goldberg stages III–V. By SD-OCT and OCT-A, thinning of the macula and flow voids in both the superficial and deep retinal capillary plexus were found in 6/30 (20%) eyes. Conclusions All 24 eyes with adequate UWFA studies demonstrated sickle retinopathy. SD-OCT and OCT-A, which have not been previously reported in the adolescent population, detected abnormal macular thinning and flow abnormalities undetected by biomicroscopy. These findings suggest that pediatric sickle retinopathy may be more prevalent than previously suspected. If these findings are confirmed with larger cross-sectional and prospective analyses, these approaches may enhance early screening for sickle retinopathy.

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Section: Discussionmentioning

confidence: 99%

“…16, 19 Finally, OCT-A has been found to provide a more accurate visualization of the macular vasculature than traditional FA. 20, 21 …”

Section: Introductionmentioning

confidence: 99%

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Optical Coherence Tomography Angiography and Ultra-widefield Fluorescein Angiography for Early Detection of Adolescent Sickle Retinopathy

Pahl

Green

Bhatia

et al. 2017

American Journal of Ophthalmology

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“…Recent evidence suggests that acute vascular events at the deep capillary plexus may be responsible for macular thinning. Using OCT angiography, Han et al 3 showed that inner retinal thinning in eyes with SCR is associated with abnormalities in the deep capillary plexus. We know that acute lesions, such as PAMM, can occur in patients with SCR due to ischaemia within the deep capillary plexus 4.…”

Section: Discussionmentioning

confidence: 99%

Paracentral acute middle maculopathy: precursor to macular thinning in sickle cell retinopathy

Hussnain¹,

Coady

Stoessel

2017

BMJ Case Reports

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We present a case of paracentral acute middle maculopathy (PAMM) in a patient with sickle cell disease (SCD). Though gradual capillary loss may contribute to pathophysiology of sickle cell retinopathy as well, our case suggests that PAMM may be the precursor lesion to macular thinning commonly observed in patients with SCD. In addition, fluorescein angiography may be unable to detect these acute vascular events occurring at the deep capillary plexus.

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“…Researchers also demonstrated the usefulness of OCTA in evaluating the response to anti-VEGF treatment [98,99] . OCTA has been demonstrated to be useful to identify the retinal vascular pathology in diseases such as macular telangiectasia Type 2 [100] , sickle cell retinopathy [101] , central serous chorioretinopathy (CSCR) [102] , and glaucoma [103] . OCTA represents a promising emerging retinal imaging modality that can potentially be applied in the screening, monitoring and treatment of retinal diseases.…”

Section: For Retinal Vein Occlusions(rvo) Kashani Et Al Reported Finmentioning

confidence: 99%

New Frontiers in Retinal Imaging

Liu

Paulus

2016

International Journal of Ophthalmic Research

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Ophthalmology is one of the most technology-driven medical specialties with numerous recent advances due to improvements in imaging technology. Advances in retinal imaging have allowed for better understanding of the eye in health and disease, retinal pathophysiology, documenting of disease progression,and assessing therapeutic response. During the last 50 years, both the hardware such as lasers in addition to software image analysis have significantly evolved. These improvements have included facilitating the progress of the ocular examination, reducing the discomfort of patients, and obtaining high quality non-invasive images. This article will review the classic retinal imaging modalities, state-of-the-art retinal imaging technologies, and an introduction of emerging imaging technologies.

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Macular Vascular Abnormalities Identified by Optical Coherence Tomographic Angiography in Patients With Sickle Cell Disease

Cited by 63 publications

References 13 publications

Optical Coherence Tomography Angiography and Ultra-widefield Fluorescein Angiography for Early Detection of Adolescent Sickle Retinopathy

Optical Coherence Tomography Angiography and Ultra-widefield Fluorescein Angiography for Early Detection of Adolescent Sickle Retinopathy

Paracentral acute middle maculopathy: precursor to macular thinning in sickle cell retinopathy

New Frontiers in Retinal Imaging

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