Croisé F, Le Lez M-L, Pisella P-J
Service d'ophtalmologie, CHU Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex, France.
J Fr Ophtalmol. 2020 Jan;43(1):7-17. doi: 10.1016/j.jfo.2019.06.024. Epub 2019 Dec 9.
Sickle cell retinopathy is the main ophthalmologic complication of sickle cell syndrome. Optical coherence tomography (OCT) and optical coherence tomography-angiography (OCT-A) permit demonstration of central retinal involvement. The goal of this study is to determine whether central retinal involvement is predictive of peripheral retinal ischemia.
We carried out a retrospective study of 31 patients with sickle cell disease who underwent a complete ophthalmologic examination. We focused on capillary density of the superficial and deep plexuses and the central avascular surface by OCT-A, and retinal layer thickness by OCT. All of the findings obtained by OCT-A and OCT were classified according to the Goldberg stages on fluorescein angiography.
A thinning of the mean and temporal deep plexus capillary layer as well as a loss of the temporal density of the superficial plexus capillaries are significantly higher in the case of proliferative sickle cell retinopathy (P=<0.05). A significant negative correlation is observed between the mean and temporal density of the superficial (R=-0.31; P=0.02 and R=-0.43; P=0.0009) and deep plexus capillaries (R=-0.39; P=0.003 et R=-0.43; P=0.0009) and the Goldberg stage in fluorescein angiography.
The study of the temporal capillary densities of the superficial and deep plexuses on OCT angiography may prove to be a useful tool for the ophthalmologist in order to diagnose patients at risk for proliferative sickle cell retinopathy.
镰状细胞视网膜病变是镰状细胞综合征的主要眼科并发症。光学相干断层扫描(OCT)和光学相干断层扫描血管造影(OCT-A)可显示视网膜中央受累情况。本研究的目的是确定视网膜中央受累是否可预测周边视网膜缺血。
我们对31例接受全面眼科检查的镰状细胞病患者进行了回顾性研究。我们通过OCT-A关注浅表和深层毛细血管丛的毛细血管密度以及中央无血管表面,并通过OCT关注视网膜层厚度。根据荧光素血管造影的戈德堡分期对OCT-A和OCT获得的所有结果进行分类。
在增殖性镰状细胞视网膜病变患者中,平均和颞侧深层毛细血管丛层变薄以及浅表毛细血管丛颞侧密度降低显著更高(P<0.05)。在荧光素血管造影中,浅表(R=-0.31;P=0.02和R=-0.43;P=0.0009)和深层毛细血管丛(R=-0.39;P=0.003和R=-0.43;P=0.0009)的平均和颞侧密度与戈德堡分期之间存在显著负相关。
在OCT血管造影上研究浅表和深层毛细血管丛的颞侧毛细血管密度可能被证明是眼科医生诊断增殖性镰状细胞视网膜病变高危患者的有用工具。