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Q. V. Hoang, F. Y. Chau, M. Shahidi, J. I. Lim; Foveal Thinning and Splaying in Sickle Cell Patients as Demonstrated by Spectral Domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2208. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Sickle cell retinopathy (SCR) occurs due to intravascular sickling, hemolysis, hemostasis and thrombosis in arterioles and capillaries. Although SCR predominantly affects the peripheral retina, macular changes have been reported with clinically-evident macular infarctions. The purpose of this study was to investigate the prevalence and degree of macular thinning on spectral domain ocular coherence tomography (SDOCT) in asymptomatic sickle cell patients.
50 eyes in 26 sickle cell patients without clinical evidence of maculopathy or ocular disease aside from SCR underwent SDOCT imaging (Spectralis, Heidelberg unit). The images were then exported and manually segmented to delineate the inner limiting membrane, nerve fiber layer (NFL), outer plexiform layer and retinal pigment epithelium using ImageJ. A dedicated program developed in Matlab was then used to measure NFL thickness, inner retinal thickness (IRT) and outer retinal thickness (ORT). Results were compared to age- and gender-matched healthy African-American controls.
Central macular thickness (CMT, central 1 mm) in sickle cell patients was 220 +/- 3 µm (mean +/- SEM), which was significantly thinner (paired t-test, p < 0.0001) than controls (240 +/- 6 µm). Parafoveal regions (between 0.5 to 1.5 mm eccentricity) showed thicknesses of 319 +/- 2 µm and 301 +/- 2 µm at nasal and temporal regions, respectively, which were significantly thinner (p < 0.02) versus controls (330 +/- 4 µm and 312 +/- 2 µm at nasal and temporal parafoveal regions, respectively). Central macular IRT was 46 +/- 2 µm versus 52 +/- 5 µm in controls (p < 0.004). There was no significant difference in IRT in para- and perifoveal (1.5 to 3 mm eccentricity) regions. Central macular ORT was 173 +/- 2 µm versus 185 +/- 2 µm in controls (p < 0.0001). Temporal para- and perifoveal regions ORT was 141 +/- 2 µm and 119 +/-1 µm, respectively versus 151 +/- 2 µm and 124 +/- 3 µm in corresponding controls (p < 0.001).
Manual segmentation of SDOCT images revealed foveal thinning and splaying in asymptomatic sickle cell patients as compared to age-matched controls. The thinning was greatest in central macular IRT.
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