title: Asymptomatic atrophy of the temporal median raphe of the retina associated with cerebral vasculopathy in homozygous sickle cell disease.
abstract: A 13-year-old girl with homozygous sickle cell disease was referred for vision loss in her left eye of 1 year's duration. Clinical findings were consistent with a past retinal arterial occlusion. In the asymptomatic right eye, spectral domain optical coherence tomography showed a severe atrophy of the inner retinal layers of the temporal median raphe; a significant internal carotid stenosis was also present. We hypothesize that specific atrophy of the retinal temporal median raphe resulted from chronic ischemia. The inner layers of the retina are vascularized by terminal vessels and the median raphe can therefore be regarded as a junction territory; its atrophy may represent an ocular equivalent of a silent border zone cerebral infarct.
authors.affiliation: Service d'Ophtalmologie, Hôpital Necker-Enfants Malades, Paris, France.
authors.forename: Matthieu P
authors.initials: MP
authors.lastname: Robert
authors.forename: Isabelle
authors.initials: I
authors.lastname: Ingster-Moati
authors.forename: Olivier
authors.initials: O
authors.lastname: Roche
authors.forename: Nathalie
authors.initials: N
authors.lastname: Boddaert
authors.forename: Mariane
authors.initials: M
authors.lastname: de Montalembert
authors.forename: Valentine
authors.initials: V
authors.lastname: Brousse
authors.forename: Manoelle
authors.initials: M
authors.lastname: Kossorotoff
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Dufier
authors.forename: Céline
authors.initials: C
authors.lastname: Faure
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D001284:Atrophy; D002343:Carotid Artery, Internal / Q000473:pathology*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D004396:Coloring Agents; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D006720:Homozygote; D006801:Humans; D007208:Indocyanine Green; D018810:Magnetic Resonance Angiography; D012160:Retina / Q000473:pathology*; D041623:Tomography, Optical Coherence; D018608:Ultrasonography, Doppler; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green