Macular Thickness in Iraqi patients with Sickle Cell Anemia

Abstract

Introduction: Sickle cell disease (SCD) is the most common genetic disease in the world. Several authors have described morphological changes from the macula to optical coherence tomography-spectral domain (OCT SD) including the thinning of the predominant inner layers in the temporal area in SCD.

Methodology: This is an analytic study conducted mainly at the specialized ophthalmology department from March 2019 to July 2023.Any SCD patient who is 20 years of age or older were involved and sickle cell patients without retinal pathology (myopia, diabetic retinopathy and vitreo-retinal interface pathology). A full ophthalmologic examination was performed. The visual acuity was taken on the Snellen scale. The near vision acuity on the Parinaud scale. Refraction was done with the Nidek auto-refractometer. Measurement of intraocular pressure by the tonometer. The slit lamp examination of the anterior segment was done. The fundus was made using the Goldman 3-Mirror glass. Retinal thickness measurements were made using a Nidek RS-3000 Advance tomograph. The thickness was measured by the macula map early treatment diabetic retinopathy study [(ETDRS) (macula map)] made of 9 fields composed of 3 concentric circles of 1 mm, 3 mm, and 6 mm in diameter. The OCT test was interpretable when the signal strength index (SSI) was greater than or equal to 7/10.

Results: Here, the median age was 32 years. There is a predominance of female vs male sex ratio = 0.56. 84% of eyes had retinal lesions suggestive of non-prolifer ative retinopathy in the retina. The solar black spots were the most found retinal lesions (68%). Lesions were more localized temporally. In the OCT measurement, 60% of the eyes showed a decreased retinal thickness SD with 78% concerning the temporal retina. There was no decrease in visual acuity in our patients who had a decrease in retinal thickness at OCT SD.

Conclusion: There is a thinning of the retinal layers in sickle cell patients in the temporal region of the macula. Patients with retinal thinning are asymptomatic with preserved visual acuity.