Vitreoretinal management of the complications of sickle cell retinopathy by observation or pars plana vitrectomy.
OBJECTIVE
To describe the management of vitreoretinal complications of sickle cell retinopathy.


METHODS
A retrospective interventional case series.


METHODS
Review of an electronic patient record and clinical notes of 27 patients with vitreoretinal complications of sickle retinopathy.


RESULTS
Six male patients and 21 female patients presented with a mean age of 41 years (range 28-67), 12 left eyes and 16 right eyes. The mean follow-up was 15.5 months (range: 3-60). Two patients were SS, and the remainders were doubly heterozygous (SC). In all, 10 were observed without surgery- three with vitreous haemorrhage, four tractional retinal detachments (TRD), and three rhegmatogenous retinal detachments (RRD). Two patients demonstrated spontaneous flattening of the retina- one RRD and one TRD. Eighteen eyes had pars plana vitrectomies (PPVs)- seven with vitreous haemorrhage, three RRD, three TRD, three ERM (one bilateral), and two macular holes. In all, 15 patients (83%) had improved vision postoperatively. The mean logMar preoperative visual acuity was 1.07 (Snellen equivalent 6/70), SD 0.62 was significantly improved postoperatively (mean 0.42 (6/15), SD 0.48, P=0.001).


CONCLUSIONS
Sickle retinopathy occasionally presents with vitreoretinal complications. These can often be observed and may spontaneously regress. If surgery is required eyes respond to vitrectomy procedures with segmentation of sea fan proliferation.
Department of Ophthalmology, St Thomas' Hospital, London, UK. tom@retinasurgery.co.uk
T H
TH
Williamson
R
R
Rajput
D A H
DA
Laidlaw
B
B
Mokete
D000328:Adult; D000368:Aged; D000755:Anemia, Sickle Cell / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012075:Remission, Spontaneous; D012163:Retinal Detachment / Q000601:surgery*; D012166:Retinal Hemorrhage / Q000601:surgery*; D012167:Retinal Perforations / Q000601:surgery*; D012189:Retrospective Studies; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D057832:Watchful Waiting / Q000379:methods*