SICKLE CELL DISEASE OPHTHALMIC MANIFESTATIONS DR.AMBREEN GULL SENIOR REGISTRAR OPHTHALMOLOGY

Sickle cell retinopathy Vaso-occlusion of peripheral arterioles of retina leading to ischemia and hypoxia

ANTERIOR SEGMENT ABNORMALITIES Hyphaema Iris infarct and atrophy Cataracts Corkscrew conjunctival vessel Phthisis bulbi

POSTERIOR SEGMENT ABNORMALITIES Optic disc changes Posterior retinal and macular vascular occlusion Sickling maculopathy Choroidal vascular occlusion Non proliferative retinal changes Proliferative retinal changes

Non proliferative retinal changes Venous tortuosity Salmon patch hemorrhage Schisis cavity(refractile iridiscent deposits) Black sunburst

Non proliferative stage

Proliferative sickle retinopathy Pheripheral arteriolar occlusions Arteriolar-venular anastomosis Neovascular proliferation Vitreous hemorrhage Retinal detachment

Proliferative stage

management Medical ocular management avoid carbonic anhydrase inhibitors If iop remains elevated early surgical intervention Goal is to eliminate neovessels Treatment modalities are argon laser photocoagulation and cryotherapy Surgical treatment scleral buckling surgery/parsplana vitrectomy