Abstract
Purpose :
To evaluate rate of progression and factors affecting retinal microvascular ischemia in patients with sickle cell disease.
Methods :
Retrospective review of 40 eyes in 25 patients diagnosed with sickle cell disease and scanned using Zeiss Cirrus-HD. We evaluated 3x3mm optical coherence tomography-angiography (OCT-A) scans at two sequential visits about 1 year apart. Vascular density (VD) was measured at the superficial (sVD) and deep (dVD) plexuses using post capture image processing platform on ImageJ (National Institute of Health). All statistical analyses were performed using SPSS, Version 27 (SPSS, Inc, Chicago, Illinois, USA).
Results :
Sickle cell status was sickle cell trait in 1, SS in 14, SC in 6, and Sb in 4 patients. Mean follow-up interval duration was 13.7 months (range: 6-25). Mean logMAR was 0.75 and 0.062 at the first and second visit, respectively. By OCT-A, the mean sVD was 51.33% (range: 41.2-57.3%) and 47.41% (range: 29.31-54.60%) while mean dVD was 46.41% (range: 37.3-53.7) and 46.43% (range: 36.61-53.18) at the first and second visit, respectively. Mean difference in VD between visits was -3.87% for sVD and +0.01% for dVD. There was a statistically significant decrease in sVD (p<0.001) but no statistically significant change in dVD (p=0.984) or VA. Subgroup analysis showed no significant difference in mean sVD reduction based on sickle cell status, history of prior stroke, and history of avascular necrosis.
Conclusions :
Over a follow-up period of 1-year, patients with sickle cell disease demonstrated progression of retinal microvascular ischemia by OCT-A. This reduction in VD appears to affect the superficial plexus more so than the deep plexus.
This is a 2021 ARVO Annual Meeting abstract.