Macular Thickness in Cameroonians Sickle Cell Patients

Abstract

Introduction: Sickle cell disease is the most common genetic disease in the world. It is particularly prevalent in Africa south of the Sahara. In Cameroon. Several authors have described morphological changes from the macula to Optical Coherence Tomography-Spectral Domain (SD OCT) including the thinning of the predominant inner layers in the temporal area. Methodology: This is a prospective analytic study. It was conducted mainly at the specialized ophthalmology department of the Army Military Application and Reference Hospital of Yaounde (HMARAY) in Cameroon. Clinical ophthalmologic exam was done and biological parameters (rate of hemoglobin, electrophoretic quantification of S hemoglobin) registered from October 2016 to June 2017.We included: Any AS patient or Cameroonian SS patient who is 20 years of age or older; sickle cell patients AS or SS without intercurrent retinal pathology (strong myopia, diabetic retinopathy, vitreoretinal interface pathology). Results: In our study the average age is 31 years. There is a predominance of female versus male sex ratio H/F=0.56. 84% of eyes had retinal lesions suggestive of non-proliferative retinopathy in the retina. The solar black spots were the most found retinal lesions (66.66%). Lesions were more localized temporally. In the OCT measurement, 60% of the eyes showed a decreased retinal thickness SD with 53% concerning the temporal retina. An hemoglobin level between 7 and 10 g/dl was found in 40% of our patients, 24% has severe anemia (hemoglobin<7 g/dl). All our patients had a percentage of hemoglobin S greater than 80%. No decrease in visual acuity in our patients who had a decrease in retinal thickness at OCT SD. Conclusion: There is a thinning of the retinal layers in SS Cameroonian sickle cell patients in the temporal region of the macula. Patients with retinal thinning are asymptomatic with preserved visual acuity.