Macular neurodegenerative and vascular changes on OCTA in sickle cell disease are not related to its ocular and systemic complications.

IF 2.3 2区医学 Q2 OPHTHALMOLOGY

Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2024-08-13 DOI:10.1097/IAE.0000000000004247

Rajani P Brandsen, Bart J Biemond, Gulsum Z Nasim, Erfan Nur, Reinier O Schlingemann, Roselie M H Diederen

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引用次数: 0

Abstract

Purpose: To evaluate macular abnormalities in sickle cell disease (SCD) with OCT-Angiography (OCTA) and to determine associations with sickle cell retinopathy (SCR) and clinical and laboratory characteristics.

Methods: Complete ophthalmic examination was performed in consecutive SCD patients (HbSS, HbSC, HbSβ0 or HbSβ+ genotype), including fundoscopy and macular SD-OCT/OCTA scans. SCR stage was based on fundoscopic examination (without fluorescein angiography) instead of the Goldberg classification, since fluorescein angiography was only used in case of tentative diagnosis. Medical/ophthalmological history and hematologic characteristics were retrieved from medical records.

Results: 249 eyes of 137 patients were analyzed. The mean age was 33.3 ± 12.4 years (range 15-70). Non-proliferative SCR was present in 57 eyes (22.9%) and proliferative SCR in 36 eyes (14.5%). Macular thinning was present in 100 eyes (40.2%) and was associated with lower foveal vessel density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) and with enlargement of the foveal avascular zone (FAZ) area, perimeter and acircularity index (AI). Age and female sex were associated with lower (para)foveal VD in the SCP and DCP. No associations were found between SCR presence/severity and macular thinning or VD.

Conclusion: Macular abnormalities were common, but did not result in visual impairment. No relation with SCR presence/severity was found. While OCTA-imaging is suitable for detecting maculopathy, it appears to have no diagnostic value in identifying patients at risk for SCR.

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镰状细胞病 OCTA 显示的黄斑神经变性和血管变化与眼部和全身并发症无关。

目的：通过OCT-血管造影（OCTA）评估镰状细胞病（SCD）的黄斑异常，并确定其与镰状细胞视网膜病变（SCR）以及临床和实验室特征之间的关联：对连续的 SCD 患者（HbSS、HbSC、HbSβ0 或 HbSβ+ 基因型）进行全面的眼科检查，包括眼底镜检查和黄斑 SD-OCT/OCTA 扫描。由于荧光素血管造影仅用于初步诊断，SCR分期基于眼底镜检查（无荧光素血管造影）而非戈德堡分类。病史/眼科病史和血液学特征均来自病历。平均年龄为 33.3 ± 12.4 岁（15-70 岁）。57眼（22.9%）存在非增殖性SCR，36眼（14.5%）存在增殖性SCR。100只眼睛（40.2%）出现黄斑变薄，这与眼窝浅层毛细血管丛（SCP）和深层毛细血管丛（DCP）血管密度（VD）降低以及眼窝无血管区（FAZ）面积、周长和弧度指数（AI）增大有关。年龄和女性性别与 SCP 和 DCP 的（副）眼窝 VD 值较低有关。SCR的存在/严重程度与黄斑变薄或VD之间没有关联：结论：黄斑异常很常见，但不会导致视力损伤。结论：黄斑异常很常见，但不会导致视力受损，与 SCR 的存在/严重程度也没有关系。虽然 OCTA 成像可用于检测黄斑病变，但在识别有 SCR 风险的患者方面似乎没有诊断价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Retina-The Journal of Retinal and Vitreous Diseases 医学-眼科学

CiteScore

5.70

自引率

9.10%

发文量

554

审稿时长

3-6 weeks

期刊介绍： RETINA® focuses exclusively on the growing specialty of vitreoretinal disorders. The Journal provides current information on diagnostic and therapeutic techniques. Its highly specialized and informative, peer-reviewed articles are easily applicable to clinical practice. In addition to regular reports from clinical and basic science investigators, RETINA® publishes special features including periodic review articles on pertinent topics, special articles dealing with surgical and other therapeutic techniques, and abstract cards. Issues are abundantly illustrated in vivid full color. Published 12 times per year, RETINA® is truly a “must have” publication for anyone connected to this field.