Spectral domain optical coherence tomography in patients with sickle cell disease

Mathew, Raeba; Bafiq, Rinoza; Ramu, Jayashree; Pearce, Elizabeth; Richardson, Matthew; Drašar, Emma; Thein, Swee Lay; Sivaprasad, Sobha

doi:10.1136/bjophthalmol-2014-305532

Cited by 78 publications

(96 citation statements)

References 16 publications

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“…These results are consistent with the previously suggested idea that HbSS patients are more likely to have macular thinning, 6 particularly temporally, compared with those with HbSC. Our findings are consistent with different patterns of sickle cell retinopathy in HbSS and HbSC patients.…”

Section: Discussionsupporting

confidence: 93%

“…Our study was undertaken to establish whether there is a difference in macular thickness between sickle cell patients with HbSS and HbSC genotypes. Mathew et al 6 reported that macular thinning was associated more with HbSS compared with HbSC eyes but were cautious in making any conclusions because of an unequal distribution of the 2 genotypes in their cohort. Their results were based on qualitative analysis of the presence of temporal thinning, whereas in our study, we used quantitative retinal thickness measurements, obtained with spectral domain optical coherence tomography (OCT).…”

mentioning

confidence: 96%

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Retinal thickness measurements in sickle cell patients with HbSS and HbSC genotype

Lim

Magan

Mahroo

et al. 2018

Canadian Journal of Ophthalmology

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ObjectiveTemporal macula thinning has been reported in sickle cell patients, but it remains unclear if there is a difference between HbSS and HbSC genotypes. We aimed to quantitatively compare macular thickness between eyes with HbSS and HbSC genotype.DesignRetrospective descriptive study.MethodsConsecutive patients seen over a 5.5-year period in the Ophthalmology Department at St Thomas’ Hospital, London, were identified. Macular optical coherence tomography images were retrospectively analyzed. The retinal thickness in all 9 subfields of the Early Treatment Diabetic Retinopathy Study (ETDRS) grid was compared between HbSS and HbSC eyes. Right eyes and left eyes were analyzed independently, as well as averaged measurements from both eyes. Comparison was made between the 2 genotypes, adjusting for age and sex, and for multiple testing. Scans were excluded in cases of poor fixation or ocular comorbidity affecting retinal thickness.Results132 HbSC and 120 HbSS patients were identified. Scans from 166 right and 153 left eyes were included (with approximately equal numbers of HbSS and HbSC genotypes). Mean retinal thickness was lower in HbSS eyes compared with HbSC eyes in all subfields of the ETDRS grid, but in most subfields the difference was <10 microns. Differences reached statistical significance for outer superior, inferior, and temporal subfields and the inner temporal subfield (p < 0.05).ConclusionAlthough the HbSC genotype is more strongly associated with proliferative retinopathy, HbSS patients had on average more macular thinning.

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 96%

Retinal thickness measurements in sickle cell patients with HbSS and HbSC genotype

Lim

Magan

Mahroo

et al. 2018

Canadian Journal of Ophthalmology

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“…32 These findings taken together suggest the potential utility of OCT-A as a non-invasive tool for screening and identifying SCD patients at a higher risk for proliferative disease. 16 The six eyes in this study that had flow voids on OCT-A and macular thinning on SD-OCT did not have corresponding neovascularization in the periphery. These patients may be at higher risk for the development of more severe peripheral ischemia.…”

Section: Discussionmentioning

confidence: 58%

“…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. 19 Finally, a recent retrospective case series found areas of macular thinning on SD-OCT correlated to the degree of peripheral ischemia observed on UWFA.…”

Section: Discussionmentioning

confidence: 83%

“…14 Additionally, proliferative sickle retinopathy has been found to be more prevalent in patients with macular thinning identified on SD-OCT suggesting the utility of SD-OCT in identifying patients at higher risk for proliferative disease. 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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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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Macular Vascular Abnormalities Identified by Optical Coherence Tomographic Angiography in Patients With Sickle Cell Disease

Han¹,

Tadarati

Scott³

2015

JAMA Ophthalmol

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Spectral domain optical coherence tomography in patients with sickle cell disease

Abstract: Quantitative and qualitative changes on SD-OCT are present in asymptomatic SCD eyes. Proliferative retinopathy is more prevalent in eyes with discrete areas of macular thinning.

Cited by 78 publications

References 16 publications

Retinal thickness measurements in sickle cell patients with HbSS and HbSC genotype

Retinal thickness measurements in sickle cell patients with HbSS and HbSC genotype

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

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

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