title: Retinal photocoagulation for proliferative sickle cell retinopathy: a prospective clinical trial with new sea fan classification.
abstract: OBJECTIVE
  To compare the clinical outcome of stage III proliferative sickle cell retinopathy (PSR) treated by peripheral retinal scatter photocoagulation to natural course disease.
  
  
  METHODS
  Long-term follow-up of 101 patients enrolled in a prospective trial of photocoagulation for PSR has been completed. Among 202 eyes of 101 patients enrolled at the University Eye Clinic of Créteil, 73 eyes showed a stage III PSR, which the authors further divided into five new grades (A, B, C, D, E) considering size, hemorrhage, fibrosis, and visible vessels. Grading was based on a three-mirror fundus examination, 360 degrees color photographs, and fluorescein angiography. Mean follow- up was 4 years.
  
  
  RESULTS
  Thirty-eight treated eyes and 35 untreated eyes were included in this study. The evolution was not statistically significant between treated and untreated groups concerning flat sea fan <1 MPS disc area (grade A) or elevated sea fan with partial fibrosis (grade C). Progression and regression were compared between the two groups for grade B, resulting statistically significant (p<0.05). Nine complications (13%) were observed, which only occurred in untreated patients with elevated sea fan and hemorrhage (grade B) or complete fibrosed sea fan with well defined vessels (grade E) (p<0.05).
  
  
  CONCLUSIONS
  These data suggest that patients with grade A or C new sea fan classification should not be initially treated but observed.
authors.affiliation: Department of Ophthalmology, University of Paris XII, Centre Hospitalier Intercommunal de Créteil, Créteil, France.
authors.forename: D
authors.initials: D
authors.lastname: Sayag
authors.forename: M
authors.initials: M
authors.lastname: Binaghi
authors.forename: E H
authors.initials: EH
authors.lastname: Souied
authors.forename: G
authors.initials: G
authors.lastname: Querques
authors.forename: F
authors.initials: F
authors.lastname: Galacteros
authors.forename: G
authors.initials: G
authors.lastname: Coscas
authors.forename: G
authors.initials: G
authors.lastname: Soubrane
mesh_terms: D000293:Adolescent; D000328:Adult; D018450:Disease Progression; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006450:Hemoglobin SC Disease / Q000145:classification / Q000601:surgery*; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015861:Retinal Neovascularization / Q000145:classification* / Q000601:surgery*; D012805:Sickle Cell Trait / Q000145:classification / Q000601:surgery*; D016896:Treatment Outcome; D014823:Vitreous Hemorrhage / Q000145:classification / Q000601:surgery*; D017086:beta-Thalassemia / Q000145:classification / Q000601:surgery*