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Edel Finke, Sadri Chahed, Chadi Mehanna, Maryse Etienne-Julan, Nathalie Lemonne, Philippe Connes, Thierry David; Maculopathy in sickle cell disease : about a macular degeneration in caribbean people. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3872.
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The purpose of our study was to detect macular diffused or localised thinnings, by using a spectral domain optical coherence tomography in a population of caribbean patients with sickle cell disease.
The undertaken study carried on 101 homozygous SS and heterozygous SC sickle cell caribbean patients who had an complete ophthalmological examination, including in particular, the visual acuity converted in logMAR scale, a dilated fundus examination to identify the sickle cell proliferative retinopathy stage, and a macular analysis by the spectral domain optical coherence tomography. The analysis concerned an eye by patient, this selected eye presented the most severe sickle cell retinopathy of both eyes. The sickle cell maculopathy was defined as being a focal or diffuse thinning down in the macular area. The statistical analyses were made by the software SPSS and had carried on the prevalence of macular thinnings down, the correlation between the severity of the sickle cell proliferative retinopathy or the heamatological parameters and the sickle cell maculopathy.
101 eyes were included, 43 patients' eyes SC and 58 patients' eyes SS . There was no association between the macular thinnings down in the OCT-SD and the genotype SS or SC, of sickle cell disease nor between the existence of a maculopathy and the severity of the proliferative retinopathy; in a multivariated analysis p=0,064. There was a significant association enters maculopathy and haematological parameters such as lowess hematocrit p=0,049 and higher reticulocyte count p=0,04. There was no significant difference of visual acuity between eyes having a macular thinning and those which have not (p > 0,05).
Sickle cell disease leads to a peripheral ischemic retinopathy but also a maculopathy. Macular infringements described are the macular ischaemia with the fluorescein angiography and the thinning of the external retina in the OCT-SD.In its novice and asymptomatic shape, this maculopathy seems to achieve the internal retina, which is also detected by the optical coherence tomography.
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