Mathew Raeba, Bafiq Rinoza, Ramu Jayashree, Pearce Elizabeth, Richardson Matthew, Drasar Emma, Thein Swee Lay, Sivaprasad Sobha
Laser and Retinal Research Unit, Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK.
Department of Hematological Medicine, King's College Hospital NHS Foundation Trust, London, UK.
Br J Ophthalmol. 2015 Jul;99(7):967-72. doi: 10.1136/bjophthalmol-2014-305532. Epub 2015 Jan 16.
To evaluate spectral domain optical coherence tomography (SD-OCT) changes in central retina and choroid in patients with sickle cell disease (SCD).
Data on visual acuity, severity of sickle cell retinopathy, macular volume scans and choroidal thickness on SD-OCT were analysed from 208 eyes of 107 consecutive patients referred for screening for SCD. The retinal and choroidal thickness of eyes with SCD were also compared with age and ethnicity matched controls.
44% of the eyes of patients with SCD showed discrete areas of retinal thinning in the temporal macular area. Proliferative sickle cell retinopathy was more prevalent in these eyes compared with SCD eyes with normal macular morphology (67% vs. 48%; p=0.0017). The temporal total and inner retinal thickness, macular volume and choroidal thickness were significantly lower in patients with SCD compared with age, gender and ethnicity matched controls. Macular splaying (widening of the macular contour) was noted in 30% of eyes in both groups. The choroidal and retinal thickness values showed good intergrader reliability using weighted κ statistics (0.550-0.9).
Quantitative and qualitative changes on SD-OCT are present in asymptomatic SCD eyes. Proliferative retinopathy is more prevalent in eyes with discrete areas of macular thinning.
评估镰状细胞病（SCD）患者中央视网膜和脉络膜的光谱域光学相干断层扫描（SD - OCT）变化。
分析了107例连续转诊来进行SCD筛查患者的208只眼睛的视力、镰状细胞视网膜病变严重程度、SD - OCT上的黄斑体积扫描和脉络膜厚度数据。还将SCD患者眼睛的视网膜和脉络膜厚度与年龄和种族匹配的对照组进行了比较。
44%的SCD患者眼睛在颞侧黄斑区出现离散的视网膜变薄区域。与黄斑形态正常的SCD眼睛相比，这些眼睛中增殖性镰状细胞视网膜病变更为普遍（67%对48%；p = 0.0017）。与年龄、性别和种族匹配的对照组相比，SCD患者的颞侧总视网膜厚度、内层视网膜厚度、黄斑体积和脉络膜厚度显著降低。两组中30%的眼睛出现黄斑展开（黄斑轮廓变宽）。使用加权κ统计量，脉络膜和视网膜厚度值显示出良好的评分者间可靠性（0.550 - 0.9）。
无症状的SCD眼睛存在SD - OCT的定量和定性变化。增殖性视网膜病变在黄斑有离散变薄区域的眼睛中更为普遍。
