Mutaf Çağrı, Hazar Leyla, Bağcıer Sevgi Polat, Vural Esra
Harran University Faculty of Medicine, Department of Ophthalmology, Sanliurfa, Turkey.
Dicle University Faculty of Medicine, Department of Ophthalmology, Diyarbakir, Turkey.
Photodiagnosis Photodyn Ther. 2025 Aug 9;55:104759. doi: 10.1016/j.pdpdt.2025.104759.
To evaluate macular vascular density (VD) and foveal avascular zone (FAZ) alterations in adult patients with sickle cell (SC) anemia without clinical signs of retinopathy using optical coherence tomography angiography (OCTA), and to compare these findings with healthy controls.
In this cross-sectional, comparative study, 18 right eyes from 18 adult patients with SC anemia and 25 right eyes from age- and sex-matched healthy individuals were analyzed. Those with SC disease were group 1 and healthy controls were group 2. All participants had normal fundus examination findings. OCTA imaging (RTVue-XR Avanti; Optovue Inc.) was used to measure vascular densities in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), as well as FAZ dimensions, using a 3 × 3 mm macular scan. Vascular density measurements were compared across eight macular sectors. Image quality below 8/10 was excluded.
The mean age of group 1 was 24.73±6.60, group 2 was 23.70±3.19 (p = 0.572). The female/male ratio was 10/8 in group 1 and 12/13 in group 2 (p = 0.500). DCP vascular density was significantly reduced in all sectors in the SC anemia group compared to controls (p < 0.001). SCP vascular density was significantly lower only in the temporal region (p = 0.015). Superficial FAZ was significantly enlarged in SC anemia patients (0.45 ± 0.09 mm²) compared to controls (0.33 ± 0.07 mm², p = 0.001), while deep FAZ did not show a statistically significant difference (p = 0.145).
Sickle cell anemia is associated with substantial microvascular compromise in the deep retinal capillary plexus, even in the absence of clinical retinopathy. OCTA proves to be a sensitive, non-invasive imaging modality capable of detecting subclinical vascular changes. Early identification of these alterations may aid in the prevention of vision-threatening complications in SC anemia.
使用光学相干断层扫描血管造影（OCTA）评估无视网膜病变临床体征的成年镰状细胞（SC）贫血患者的黄斑血管密度（VD）和中心凹无血管区（FAZ）变化，并将这些结果与健康对照者进行比较。
在这项横断面比较研究中，分析了18例成年SC贫血患者的18只右眼和年龄及性别匹配的健康个体的25只右眼。患有SC疾病的患者为第1组，健康对照者为第2组。所有参与者眼底检查结果均正常。使用OCTA成像（RTVue-XR Avanti；Optovue公司）通过3×3mm黄斑扫描测量浅表毛细血管丛（SCP）和深部毛细血管丛（DCP）的血管密度以及FAZ大小。比较了八个黄斑区域的血管密度测量值。图像质量低于8/10的被排除。
第1组的平均年龄为24.73±6.60岁，第2组为23.70±3.19岁（p = 0.572）。第1组的女性/男性比例为10/8，第2组为12/13（p = 0.500）。与对照组相比，SC贫血组所有区域的DCP血管密度均显著降低（p < 0.001）。仅颞侧区域的SCP血管密度显著降低（p = 0.015）。与对照组（0.33±0.07mm²，p = 0.001）相比，SC贫血患者的浅表FAZ显著增大（0.45±0.09mm²），而深部FAZ无统计学显著差异（p = 0.145）。
即使没有临床视网膜病变，镰状细胞贫血也与视网膜深部毛细血管丛的大量微血管损害有关。OCTA被证明是一种能够检测亚临床血管变化的敏感、非侵入性成像方式。早期识别这些变化可能有助于预防SC贫血中威胁视力的并发症。
