title: Macular Microangiopathy in Sickle Cell Disease Using Optical Coherence Tomography Angiography.
abstract: OBJECTIVE
  To characterize the optical coherence tomography angiography (OCTA) appearance of the perifoveal macular microvasculature in visually asymptomatic patients with sickle cell disease, and to compare these findings with those of fluorescein angiography (FA).
  
  
  METHODS
  Retrospective observational case series.
  
  
  METHODS
  Eighteen eyes of 9 consecutive patients with a median age of 41 years (range: 19-54 years) with electrophoretic confirmation of sickle cell disease were included and analyzed. A complete ophthalmologic examination was performed, including fundus examination, FA, and OCTA. Nine eyes of 5 healthy subjects were also analyzed with OCTA to serve as a control group.
  
  
  RESULTS
  OCTA demonstrated microvascular abnormalities in the perifoveal region of the macula in all eyes, whereas FA appeared normal in 9 of 18 eyes (50%). Most capillary abnormalities were located in the temporal juxtafoveal region and involved both the superficial and the deep capillary plexuses. The nonflow area (foveal avascular zone) was significantly larger in sickle cell disease patients than in the control group, both in the superficial and the deep capillary plexuses (P < .0001). The perifoveal vessel density was significantly lower in the sickle cell disease patients than in the control group in both the superficial (P = .0011) and the deep capillary plexuses (P = .0018).
  
  
  CONCLUSIONS
  OCTA provided detailed imaging of the perifoveal microvasculature in sickle cell disease. It appeared more sensitive than FA in detecting macular microangiopathy in asymptomatic patients. Microvascular abnormalities in sickle cell disease involved both the superficial and the deep capillary plexuses.
authors.affiliation: University Eye Clinic, Centre Hospitalier Intercommunal de Créteil, University Paris Est, Créteil, France.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Minvielle
authors.affiliation: University Eye Clinic, Centre Hospitalier Intercommunal de Créteil, University Paris Est, Créteil, France.
authors.forename: Violaine
authors.initials: V
authors.lastname: Caillaux
authors.affiliation: University Eye Clinic, Centre Hospitalier Intercommunal de Créteil, University Paris Est, Créteil, France; Centre Ophtalmologique d'Imagerie et de Laser, Paris, France.
authors.forename: Salomon Y
authors.initials: SY
authors.lastname: Cohen
authors.affiliation: Department of Dermatology and Allergology, AP-HP, Hôpital Tenon, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Chasset
authors.affiliation: University Eye Clinic, Centre Hospitalier Intercommunal de Créteil, University Paris Est, Créteil, France.
authors.forename: Olivia
authors.initials: O
authors.lastname: Zambrowski
authors.affiliation: University Eye Clinic, Centre Hospitalier Intercommunal de Créteil, University Paris Est, Créteil, France.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Miere
authors.affiliation: University Eye Clinic, Centre Hospitalier Intercommunal de Créteil, University Paris Est, Créteil, France. Electronic address: eric.souied@chicreteil.fr.
authors.forename: Eric H
authors.initials: EH
authors.lastname: Souied
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000175:diagnosis*; D005260:Female; D005451:Fluorescein Angiography; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008875:Middle Aged; D012164:Retinal Diseases / Q000175:diagnosis*; D012171:Retinal Vessels / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D055815:Young Adult