Giocanti-Aurégan Audrey, Fajnkuchen Franck
Hôpital Avicenne, Bobigny, France.
Centre D'imagerie et de Laser, Paris, France.
Case Rep Ophthalmol. 2023 Apr 11;14(1):159-164. doi: 10.1159/000529479. eCollection 2023 Jan-Dec.
Sickle cell proliferative retinopathy usually presents first in the peripheral retina and the ability to extend and enhance our visualization of the peripheral retina would allow for superior clinical decision-making. In our practice, we had a 28-year-old patient diagnosed with major sickle cell disease of the homozygous type SS (HbSS) that presented with sickle cell proliferative retinopathy detected by ultra-widefield imaging in the nasal side of the left fundus. At follow-up, neovascularization was detected in the extreme nasal periphery of the left eye by ultra-widefield imaging fluorescein angiography with right gaze. The case was graded as Goldberg stage 3, and the patient was administered photocoagulation treatment. With further advancements in the quality and modality of peripheral retinal imaging, novel proliferative lesions can be detected and appropriately managed much earlier than was previously possible. Ultra-widefield imaging allows for the visualization of the central 200 degrees of the retina but, with gaze view, peripheral retina beyond 200 degrees can be reached.
镰状细胞增殖性视网膜病变通常首先出现在周边视网膜,而扩展并增强我们对周边视网膜的可视化能力将有助于做出更优的临床决策。在我们的临床实践中,有一名28岁的患者,被诊断为纯合子型SS(HbSS)重度镰状细胞病,通过超广角成像在左眼眼底鼻侧检测到镰状细胞增殖性视网膜病变。在随访中,通过超广角成像荧光素血管造影并采用右眼注视,在左眼极鼻侧周边检测到新生血管形成。该病例被分级为戈德堡3期,并对患者进行了光凝治疗。随着周边视网膜成像质量和方式的进一步发展,可以比以前更早地检测到新的增殖性病变并进行适当处理。超广角成像可以可视化视网膜中央200度的范围,但通过注视视角,可以观察到超过200度的周边视网膜。