title: [Prevalence and risk factors for sickle retinopathy in a sub-Saharan comprehensive Sickle Cell Center].
abstract: BACKGROUND
  Retinopathy is a chronic complication with severe functional consequences in patients with sickle cell disease. Its prevalence is not well known in sub-Saharan Africa because of the absence of screening. We report here the results of a routine screening for sickle retinopathy in a Comprehensive Sickle Cell Center in Sub-Saharan Africa.
  
  
  METHODS
  Screening of sickle retinopathy was carried out in all sickle cell patients aged 10 and over, followed between 2010 and 2012. Retinopathy was screened by dilated indirect fundoscopic examination and retinal angiography, if necessary. The gender, age and hematological parameters of patients with sickle retinopathy were compared with those of controls randomly selected from the cohort of sickle cell patients without retinopathy followed during the same period.
  
  
  RESULTS
  The overall prevalence of sickle cell retinopathy was 8.8% (142/1604): 12.4% (91/731) in SC, 5.2% (38/734) in SS, 9.4% (5/53) in Sβ°-thalassemia patients and 9.3% (8/86) in Sβ+-thalassemia patients. Proliferative retinopathy was more common in SC patients (P<0.01). High levels of hemoglobin or of hematocrit were associated with retinopathy in all patients and with proliferative retinopathy in SC patients. In SS or Sβ0thalassemia patients, high leukocyte count was associated with proliferative retinopathy. Low fetal hemoglobin level was associated with retinopathy in all groups.
  
  
  CONCLUSIONS
  The prevalence of sickle cell retinopathy is high and negatively associated to the level of fetal hemoglobin. The efficiency of a routine screening for sickle cell retinopathy must be assessed in Africa as well as the benefit of phlebotomy and hydroxyurea therapy as a preventive treatments.
authors.affiliation: Centre de recherche et de lutte contre la drépanocytose (CRLD), point G, commune III, 03 BP 186, BKO 03, Bamako, Mali.
authors.forename: A K
authors.initials: AK
authors.lastname: Dembélé
authors.affiliation: Centre de recherche et de lutte contre la drépanocytose (CRLD), point G, commune III, 03 BP 186, BKO 03, Bamako, Mali.
authors.forename: B A
authors.initials: BA
authors.lastname: Toure
authors.affiliation: Centre de recherche et de lutte contre la drépanocytose (CRLD), point G, commune III, 03 BP 186, BKO 03, Bamako, Mali.
authors.forename: Y S
authors.initials: YS
authors.lastname: Sarro
authors.affiliation: Centre de recherche et de lutte contre la drépanocytose (CRLD), point G, commune III, 03 BP 186, BKO 03, Bamako, Mali.
authors.forename: A
authors.initials: A
authors.lastname: Guindo
authors.affiliation: Centre de recherche et de lutte contre la drépanocytose (CRLD), point G, commune III, 03 BP 186, BKO 03, Bamako, Mali.
authors.forename: B
authors.initials: B
authors.lastname: Fané
authors.affiliation: UMR_S970, Inserm, hôpital européen Georges-Pompidou, AP-HP, université Paris Descartes, 15, rue Le-Blanc, 75908 Paris cedex 15, France.
authors.forename: L
authors.initials: L
authors.lastname: Offredo
authors.affiliation: Centre de recherche et de lutte contre la drépanocytose (CRLD), point G, commune III, 03 BP 186, BKO 03, Bamako, Mali.
authors.forename: S
authors.initials: S
authors.lastname: Kené
authors.affiliation: Institut d'ophtalmologie tropicale de l'Afrique de l'Ouest (IOTA), Bamako, Mali.
authors.forename: I
authors.initials: I
authors.lastname: Conaré
authors.affiliation: Centre de recherche et de lutte contre la drépanocytose (CRLD), point G, commune III, 03 BP 186, BKO 03, Bamako, Mali.
authors.forename: O
authors.initials: O
authors.lastname: Tessougué
authors.affiliation: Centre de recherche et de lutte contre la drépanocytose (CRLD), point G, commune III, 03 BP 186, BKO 03, Bamako, Mali.
authors.forename: Y
authors.initials: Y
authors.lastname: Traoré
authors.affiliation: Centre de recherche et de lutte contre la drépanocytose (CRLD), point G, commune III, 03 BP 186, BKO 03, Bamako, Mali.
authors.forename: Y
authors.initials: Y
authors.lastname: Badiaga
authors.affiliation: Centre de recherche et de lutte contre la drépanocytose (CRLD), point G, commune III, 03 BP 186, BKO 03, Bamako, Mali.
authors.forename: M B
authors.initials: MB
authors.lastname: Sidibé
authors.affiliation: Centre de recherche et de lutte contre la drépanocytose (CRLD), point G, commune III, 03 BP 186, BKO 03, Bamako, Mali.
authors.forename: D
authors.initials: D
authors.lastname: Diabaté
authors.affiliation: Centre de recherche et de lutte contre la drépanocytose (CRLD), point G, commune III, 03 BP 186, BKO 03, Bamako, Mali.
authors.forename: M
authors.initials: M
authors.lastname: Coulibaly
authors.affiliation: Centre de recherche et de lutte contre la drépanocytose (CRLD), point G, commune III, 03 BP 186, BKO 03, Bamako, Mali.
authors.forename: M
authors.initials: M
authors.lastname: Kanta
authors.affiliation: UMR_S970, Inserm, hôpital européen Georges-Pompidou, AP-HP, université Paris Descartes, 15, rue Le-Blanc, 75908 Paris cedex 15, France.
authors.forename: B
authors.initials: B
authors.lastname: Ranque
authors.affiliation: Centre de recherche et de lutte contre la drépanocytose (CRLD), point G, commune III, 03 BP 186, BKO 03, Bamako, Mali; Service d'hématologie-oncologie médicale du CHU du point G, BP 333, Bamako, Mali. Electronic address: dadiallo@icermali.org.
authors.forename: D A
authors.initials: DA
authors.lastname: Diallo
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006782:Hospitals, Special; D006801:Humans; D008297:Male; D015995:Prevalence; D012164:Retinal Diseases / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors; D055815:Young Adult
keywords: Drépanocytose; Epidemiology; Hydroxycarbamide; Hydroxyurea; Mali; Phlebotomy; Phlébotomie; Retinopathy; Rétinopathie; Sickle cell disease; Épidémiologie