Penman A D, Serjeant G R
Medical Research Council Laboratories, University of the West Indies, Kingston, Jamaica.
Curr Opin Ophthalmol. 1992 Jun;3(3):379-88. doi: 10.1097/00055735-199206000-00013.
Sickle cell eye disease is characterized by microvascular occlusion that affects the peripheral retinal vasculature and results in retinal ischemia and the development of proliferative sickle cell retinopathy. Complications of proliferative sickle cell retinopathy such as vitreous hemorrhage and retinal detachment are the most common causes of visual loss in this disease. Prevention of this visual loss is therefore contingent on the prevention or early detection and treatment of proliferative sickle cell retinopathy. Most effort has been directed toward therapy for established proliferative sickle cell retinopathy, and several therapeutic trials have been reported. Much less is known about the risk factors for development of proliferative sickle cell retinopathy and its natural history, in particular the true incidence of permanent visual loss. Visual loss is believed to be predominantly a complication of perfused proliferative sickle cell retinopathy, and its autoinfarction renders such visual loss less likely. To better define the place of treatment, identification of the determinants of autoinfarction is required, but identification of patients whose proliferative sickle cell retinopathy is likely to proceed to visual loss is of greater importance.
镰状细胞眼病的特征是微血管阻塞，影响周边视网膜血管系统，导致视网膜缺血和增殖性镰状细胞视网膜病变的发展。增殖性镰状细胞视网膜病变的并发症，如玻璃体出血和视网膜脱离，是该疾病视力丧失的最常见原因。因此，预防这种视力丧失取决于预防或早期发现和治疗增殖性镰状细胞视网膜病变。大多数努力都集中在已确诊的增殖性镰状细胞视网膜病变的治疗上，并且已经报道了几项治疗试验。关于增殖性镰状细胞视网膜病变的发展风险因素及其自然史，特别是永久性视力丧失的真实发生率，人们了解得要少得多。视力丧失被认为主要是灌注性增殖性镰状细胞视网膜病变的并发症，而其自身梗死使这种视力丧失的可能性降低。为了更好地确定治疗的地位，需要确定自身梗死的决定因素，但确定增殖性镰状细胞视网膜病变可能导致视力丧失的患者更为重要。
