Researchers who undertook a large retrospective review on sickle cell disease among children were surprised to find that one in three youngsters had retinotherapy, usually an age-dependent condition, with older people being at far higher risk, generally, than younger patients.
The team from the University of Tennessee Health Science Centre, who had conducted the review at their institution, said 9% of the children required treatment, suggesting children need to be screened for vision problems as often as adults with sickle cell disease.
The study was presented this week at AAO 2023, the 127th annual meeting of the American Academy of Ophthalmology, in San Francisco.
“Our data underscore the need for patients – including paediatric patients – with sickle cell disease to have routine ophthalmic screenings, along with appropriate systemic and ophthalmic treatment,” said lead researcher Mary Ellen Hoehn, MD, professor of Ophthalmology at University of Tennessee Health Science Centre.
She and her colleagues also evaluated the effectiveness of different therapies for sickle cell disease. They found that hydroxyurea and chronic transfusions were associated with decreased rates of retinopathy, even when accounting for different genotypes.
To conduct the study, they evaluated records for 652 patients, aged 10 to 25 (median age: 14) who underwent eye exams (2 240 visits) over a 12-year period. They found:
• 33% had non-proliferative retinopathy (NPR)
• 6% had proliferative retinopathy (PR).
• 33 eyes were treated with pan-retinal photocoagulation, most commonly for PR stage 3 (43%). Intravitreal anti-VEGF therapy was given to five eyes, all with PR.
Other complications included retinal detachment and retinal artery occlusion in two patients each.
Vision loss (final best corrected visual acuity 20/60) after complications from sickle cell disease was noted in only one patient with a central retinal artery occlusion.
“We hope that people will use this information to better care for patients with sickle cell disease, and that more timely ophthalmic screen exams will be performed so that vision-threatening complications from this disease are prevented,” Hoehn said.
• No abstract available
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