Retinal thickness and macular microvascular changes seen on optical coherence tomography angiography (OCTA) in patients with sickle cell retinopathy in a tertiary care eye hospital

JFO Open Ophthalmology Pub Date : 2024-09-18 DOI:10.1016/j.jfop.2024.100138

Olufemi Oderinlo, Oyekunle Idris, Lateefat Oshunkoya, Adekunle Hassan, Abiodun Olukotun

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Abstract

Purpose

To report retinal thickness values and macular vascular flow characteristics identified by optical coherence tomography angiography (OCT-A) in patients with various sickle cell genotypes in a population from sub-Saharan Africa.

Design

Retrospective, observational study.

Methods

This is a single-institution case series of adult patients with various sickle cell genotypes who presented to the Eye Foundation Hospital Lagos between January 2022 and December 2023. Case files of patients were reviewed, and macular OCT and OCT-A images analyzed quantitatively for macular thickness, areas of flow loss, size of foveal avascular area, parafoveal flow, as well as vascular density in both the superficial and deep vascular plexi. The findings were compared by sickle cell genotype and comparisons made with age matched normal patients.

Results

A total of 38 eyes of 19 patients’ records were reviewed, and 35 eyes met the inclusion criteria; 16 eyes of 9 age and gender matched controls were included. The mean central foveal thickness (CFT) was 242.4 μm ± 33.3 μm among patients’ eyes, while a mean CFT of 236.1 μm ± 10.1 μm was measured among controls (p = 0.312). A smaller mean FAZ area of 0.270 mm² ± 0.116 mm² was seen among the control eyes compared to a mean of 0.314 mm² ± 0.206 mm² among patients’ eyes (p = 0.439). The mean flow area was larger among control eyes with 0.849 mm² ± 0.647 mm² compared to a mean flow of 0.822 mm² ± 0.471 mm² among patients’ eyes (0.868). The mean superficial foveal vessel density was greater among control eyes (19.30 ± 4.58) compared to patient eyes (18.77 ± 7.78) (p = 0.765). The mean deep foveal vessel density was greater among controls (35.30 ± 8.36) than among patients (34.06 ± 9.30) (p = 0.650). The difference between eyes of SC (53.37 ± 5.13) patients and SS (47.94 ± 8.44) patients in the deep temporal perifoveal VD was statistically significant (p = 0.035).

Conclusion

The retina in eyes with sickle retinopathy and that of controls tends to be thickest in the nasal quadrant, then the superior, then inferior, and then thinnest in the temporal quadrant. Macular vessel density in both the superficial and deep capillary plexi was thicker among controls compared to eyes with sickle cell retinopathy. Among patients’ eyes, the deep capillary vessel density in the temporal perifoveal quadrant was greater among SC patients compared to SS (p = 0.035).

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一家三级眼科医院镰状细胞视网膜病变患者的光学相干断层血管造影（OCTA）所见视网膜厚度和黄斑微血管变化

目的报告撒哈拉以南非洲地区不同镰状细胞基因型患者的视网膜厚度值和通过光学相干断层血管造影（OCT-A）确定的黄斑血管流动特征。方法这是一项单机构病例系列研究，研究对象是 2022 年 1 月至 2023 年 12 月期间在拉各斯眼科基金会医院就诊的不同镰状细胞基因型成年患者。对患者的病例档案进行了审查，并对黄斑 OCT 和 OCT-A 图像进行了定量分析，以了解黄斑厚度、血流损失区域、眼窝无血管区域的大小、眼窝旁血流以及浅层和深层血管丛的血管密度。结果共审查了 19 名患者的 38 眼病历，其中 35 眼符合纳入标准；纳入了 9 名年龄和性别匹配的对照组患者的 16 眼病历。患者的平均中央眼窝厚度（CFT）为 242.4 μm ± 33.3 μm，而对照组的平均中央眼窝厚度为 236.1 μm ± 10.1 μm（P = 0.312）。对照组眼睛的平均 FAZ 面积较小，为 0.270 mm2 ± 0.116 mm2，而患者眼睛的平均 FAZ 面积为 0.314 mm2 ± 0.206 mm2（p = 0.439）。对照组眼睛的平均血流面积更大，为 0.849 mm2 ± 0.647 mm2，而患者眼睛的平均血流面积为 0.822 mm2 ± 0.471 mm2 (0.868)。对照组眼睛的平均眼窝浅层血管密度（19.30 ± 4.58）高于患者眼睛（18.77 ± 7.78）（p = 0.765）。对照组眼窝深层血管密度平均值（35.30 ± 8.36）高于患者眼窝深层血管密度平均值（34.06 ± 9.30）（p = 0.650）。结论镰状视网膜病变患者的视网膜与对照组相比，往往是鼻侧象限最厚，然后是上部，然后是下部，然后是颞侧象限最薄。与镰状细胞视网膜病变患者的眼睛相比，对照组浅层和深层毛细血管丛中的黄斑血管密度都更粗。在患者眼中，与镰状细胞视网膜病变患者相比，镰状细胞视网膜病变患者颞叶周围象限的深层毛细血管密度更高（p = 0.035）。

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JFO Open Ophthalmology

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