Vatansever Esra, Vatansever Mustafa, Dinç Erdem, Temel Gülhan Ö, Ünal Selma
Erdemli State Hospital, Pediatrics Clinic.
Toros State Hospital, Ophthalmology Clinic.
J Pediatr Hematol Oncol. 2020 Mar;42(2):92-99. doi: 10.1097/MPH.0000000000001678.
The aim of this study was to compare optical coherence tomography (OCT) findings in pediatric patients with sickle cell disease (SCD) and healthy individuals and to investigate associations between these data and the patients' systemic findings.
The study included 108 eyes of 54 patients with SCD with no visual symptoms and a control group consisting of 110 eyes of 55 healthy subjects with no systemic or ocular pathology. After best-corrected visual acuity assessment, the study participants underwent a complete ophthalmologic examination including intraocular pressure. After examination and pupil dilation induced with 1% tropicamide, 9×9 mm macular sections were obtained with spectral-domain OCT. The macular sections were evaluated according to Early Treatment Diabetic Retinopathy Study (ETDRS) map and internal and external retinal thicknesses were measured using the software included in the OCT device.
The patient group showed significantly more foveal flattening, temporal thinning, and vascular tortuosity than the control group (P<0.0001 for all). Foveal width was significantly greater in the patient group (1592.39±175.56 µm) compared with the control group (1391.01±175.56 µm) (P<0.0001), whereas foveal depth was significantly lower in the patient group (121.15±26.83 µm) than in the control group (146.1±12.25 µm) (P<0.0001). The mean total retinal thickness was 253.53±22.31 µm in the patient group and 261.03±18.48 µm in the control group (P=0.007). Similarly, central retinal thickness was significantly lower in the patient group (219.35±10.53 µm) compared with the control group (235.32±12.51 µm) (P<0.0001).
Our study shows that pediatric patients with SCD may have subclinical retinal involvement and that temporal thinning, in particular, is an important OCT finding. This strongly suggests that OCT imaging would be a beneficial addition to routine ophthalmologic examination in the diagnosis and follow-up of this patient group.
本研究旨在比较镰状细胞病(SCD)患儿与健康个体的光学相干断层扫描(OCT)结果,并调查这些数据与患者全身检查结果之间的关联。
本研究纳入了54例无视觉症状的SCD患者的108只眼,以及由55名无全身或眼部病变的健康受试者的110只眼组成的对照组。在进行最佳矫正视力评估后,研究参与者接受了包括眼压测量在内的全面眼科检查。在检查并用1%托吡卡胺散瞳后,使用光谱域OCT获取9×9 mm的黄斑区图像。根据早期糖尿病性视网膜病变研究(ETDRS)图谱对黄斑区图像进行评估,并使用OCT设备附带的软件测量视网膜内外层厚度。
患者组的黄斑中心凹变平、颞侧变薄和血管迂曲程度均显著高于对照组(所有P<0.0001)。患者组的黄斑中心凹宽度(1592.39±175.56 µm)显著大于对照组(1391.01±175.56 µm)(P<0.0001),而患者组的黄斑中心凹深度(121.15±26.83 µm)显著低于对照组(146.1±12.25 µm)(P<0.0001)。患者组的平均视网膜总厚度为253.53±22.31 µm,对照组为261.03±18.48 µm(P=0.007)。同样,患者组的中心视网膜厚度(219.35±10.53 µm)显著低于对照组(235.32±12.51 µm)(P<0.0001)。
我们的研究表明,SCD患儿可能存在亚临床视网膜病变,尤其是颞侧变薄是OCT的一项重要发现。这强烈表明,OCT成像将是该患者群体诊断和随访中常规眼科检查的有益补充。