Macular microvascular alterations in adults with sickle cell anemia detected by optical coherence tomography angiography

IF 2.6 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-08-09 DOI:10.1016/j.pdpdt.2025.104759

Çağrı Mutaf , Leyla Hazar , Sevgi Polat Bağcıer , Esra Vural

{"title":"Macular microvascular alterations in adults with sickle cell anemia detected by optical coherence tomography angiography","authors":"Çağrı Mutaf , Leyla Hazar , Sevgi Polat Bağcıer , Esra Vural","doi":"10.1016/j.pdpdt.2025.104759","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate macular vascular density (VD) and foveal avascular zone (FAZ) alterations in adult patients with sickle cell (SC) anemia without clinical signs of retinopathy using optical coherence tomography angiography (OCTA), and to compare these findings with healthy controls.</div></div><div><h3>Methods</h3><div>In this cross-sectional, comparative study, 18 right eyes from 18 adult patients with SC anemia and 25 right eyes from age- and sex-matched healthy individuals were analyzed. Those with SC disease were group 1 and healthy controls were group 2. All participants had normal fundus examination findings. OCTA imaging (RTVue-XR Avanti; Optovue Inc.) was used to measure vascular densities in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), as well as FAZ dimensions, using a 3 × 3 mm macular scan. Vascular density measurements were compared across eight macular sectors. Image quality below 8/10 was excluded.</div></div><div><h3>Results</h3><div>The mean age of group 1 was 24.73±6.60, group 2 was 23.70±3.19 (<em>p</em> = 0.572). The female/male ratio was 10/8 in group 1 and 12/13 in group 2 (<em>p</em> = 0.500). DCP vascular density was significantly reduced in all sectors in the SC anemia group compared to controls (<em>p</em> < 0.001). SCP vascular density was significantly lower only in the temporal region (<em>p</em> = 0.015). Superficial FAZ was significantly enlarged in SC anemia patients (0.45 ± 0.09 mm²) compared to controls (0.33 ± 0.07 mm², <em>p</em> = 0.001), while deep FAZ did not show a statistically significant difference (<em>p</em> = 0.145).</div></div><div><h3>Conclusion</h3><div>Sickle cell anemia is associated with substantial microvascular compromise in the deep retinal capillary plexus, even in the absence of clinical retinopathy. OCTA proves to be a sensitive, non-invasive imaging modality capable of detecting subclinical vascular changes. Early identification of these alterations may aid in the prevention of vision-threatening complications in SC anemia.</div></div>","PeriodicalId":20141,"journal":{"name":"Photodiagnosis and Photodynamic Therapy","volume":"55 ","pages":"Article 104759"},"PeriodicalIF":2.6000,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Photodiagnosis and Photodynamic Therapy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1572100025002911","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

To evaluate macular vascular density (VD) and foveal avascular zone (FAZ) alterations in adult patients with sickle cell (SC) anemia without clinical signs of retinopathy using optical coherence tomography angiography (OCTA), and to compare these findings with healthy controls.

Methods

In this cross-sectional, comparative study, 18 right eyes from 18 adult patients with SC anemia and 25 right eyes from age- and sex-matched healthy individuals were analyzed. Those with SC disease were group 1 and healthy controls were group 2. All participants had normal fundus examination findings. OCTA imaging (RTVue-XR Avanti; Optovue Inc.) was used to measure vascular densities in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), as well as FAZ dimensions, using a 3 × 3 mm macular scan. Vascular density measurements were compared across eight macular sectors. Image quality below 8/10 was excluded.

Results

The mean age of group 1 was 24.73±6.60, group 2 was 23.70±3.19 (p = 0.572). The female/male ratio was 10/8 in group 1 and 12/13 in group 2 (p = 0.500). DCP vascular density was significantly reduced in all sectors in the SC anemia group compared to controls (p < 0.001). SCP vascular density was significantly lower only in the temporal region (p = 0.015). Superficial FAZ was significantly enlarged in SC anemia patients (0.45 ± 0.09 mm²) compared to controls (0.33 ± 0.07 mm², p = 0.001), while deep FAZ did not show a statistically significant difference (p = 0.145).

Conclusion

Sickle cell anemia is associated with substantial microvascular compromise in the deep retinal capillary plexus, even in the absence of clinical retinopathy. OCTA proves to be a sensitive, non-invasive imaging modality capable of detecting subclinical vascular changes. Early identification of these alterations may aid in the prevention of vision-threatening complications in SC anemia.

查看原文本刊更多论文

光学相干断层扫描血管造影检测成人镰状细胞性贫血的黄斑微血管改变。

目的：利用光学相干断层扫描血管造影（OCTA）评估无视网膜病变临床体征的成年镰状细胞（SC）贫血患者黄斑血管密度（VD）和中央凹无血管带（FAZ）的改变，并将这些结果与健康对照进行比较。方法：在这项横断面比较研究中，对18名成年SC贫血患者的18只右眼和年龄和性别匹配的健康个体的25只右眼进行了分析。SC患者为1组，健康对照组为2组。所有参与者眼底检查结果均正常。OCTA成像(RTVue-XR Avanti；使用Optovue Inc.)使用3×3 mm黄斑扫描测量浅毛细血管丛（SCP）和深毛细血管丛（DCP）的血管密度以及FAZ尺寸。比较了八个黄斑区域的血管密度测量值。8/10以下的图像质量被排除在外。结果：1组患者平均年龄24.73±6.60岁，2组患者平均年龄23.70±3.19岁（p=0.572）。1组男女比例为10/8,2组为12/13 （p=0.500）。与对照组相比，SC贫血组所有部位的DCP血管密度显著降低（p < 0.001）。SCP血管密度仅在颞区明显降低（p = 0.015）。SC贫血患者浅表FAZ与对照组（0.33±0.07 mm²，p = 0.001）相比显著增大（0.45±0.09 mm²），深部FAZ差异无统计学意义（p = 0.145）。结论：镰状细胞性贫血与视网膜深部毛细血管丛大量微血管受损有关，即使在没有临床视网膜病变的情况下。OCTA被证明是一种敏感的、非侵入性的成像方式，能够检测亚临床血管变化。早期识别这些改变可能有助于预防SC贫血中威胁视力的并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.