Intravitreal Ranibizumab for Stage IV Proliferative Sickle Cell Retinopathy: A First Case Report (original) (raw)
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Sickle cell retinopathy: improving care with a multidisciplinary approach
Journal of multidisciplinary healthcare, 2017
Sickle cell retinopathy (SCR) is the most representative ophthalmologic complication of sickle cell disease (SCD), a hemoglobinopathy affecting both adults and children. SCR presents a wide spectrum of manifestations and may even lead to irreversible vision loss if not properly diagnosed and treated at the earliest. Over the past decade, multidisciplinary research developments have focused upon systemic, genetic, and ocular risk factors of SCR, enabling the clinician to better diagnose and manage these patients. In addition, newer imaging and testing modalities, such as spectral domain-optical coherence tomography angiography, have resulted in the detection of subclinical retinopathy related to SCD. Innovative therapy includes intravitreal injection of an anti-vascular endothelial growth factor (eg, Lucentis(®) [ranibizumab] or Eylea(®) [aflibercept]) which appears comparatively safe and efficient, and may be combined with laser photocoagulation (LPC) for proliferative SCR. The effe...
Journal of Global Medicine
Topic: A review of outcomes of laser photocoagulation for Goldberg stage 3 proliferative sickle cell retinopathy (PSR) in a Eye Foundation Hospital. Aims and objectives: To report regression of retina neovascularization and visual outcomes after prophylactic scatter retina laser photocoagulation for Goldberg stage 3 PSR in a tertiary private hospital in sub-Saharan Africa. Methods: A retrospective review of case files of patients who were treated with prophylactic scatter retina laser photocoagulation between January 2017 and June 2022 following a diagnosis of PSR in a Eye Foundation Hospital, Ikeja, Lagos, Nigeria, was done. Results: A total of 124 eyes of 62 patients with PSR were seen within the period under consideration. A majority of patients (49 (79.0%)) had hemoglobin (Hb) genotype SC, while 13 patients (21%) were Hb genotype SS. At presentation, 29 eyes (23.3%) had Goldberg stage 2 PSR, 55 eyes (44.4%) had Goldberg stage 3 PSR, 27 eyes (21.8%) had stage 4 PSR, while 13 eyes...
Sickle cell retinopathy: A literature review
Revista da Associacao Medica Brasileira, 2017
Hemoglobinopathies are a group of hereditary diseases that cause quantitative or qualitative changes in the shape, function or synthesis of hemoglobin. One of the most common is sickle cell anemia, which, due to sickling of erythrocytes, causes vaso-occlusive phenomena. Among the possible ocular manifestations, the most representative is retinopathy, which can lead to blindness if left untreated. Therefore, periodic ophthalmologic monitoring of these patients is important for early diagnosis and adequate therapeutic management, which can be done localy by treating the lesions in the eyes, or systemically.
Ophthalmology, 1986
Forty-four patients (70 eyes, 220 sea fans) with proliferative sickle retinopathy (PSR) received peripheral circumferential retinal scatter photocoagulation (PCRP) to the peripheral zones of retinal capillary nonperfusion. With an average follow-up of 3.3 years, 33% of preexisting sea fans regressed completely, 46% regressed partially, 19% remained stable, and 2% showed progression. De novo neovascularization developed after treatment in only one eye (1.4%). Ninety-five percent of patients treated had a final visual acuity of 20/30 or better and only one patient (2%) developed a nonresolving vitreous hemorrhage requiring vitrectomy surgery. These results confirm the authors' previous report and continue to compare favorably to the natural history of PSR in which de novo lesions developed in 58%, and 12% of eyes ended with a visual acuity of 20/200 or less. PCRP seems preferable to other techniques in reducing the risk of nonresolving vitreous hemorrhage and/or traction retinal detachment, although randomized controlled studies are needed to conclusively assess the safety and efficacy of this strategy in treating PSR.
Ophthalmology, 2005
To describe the incidence, prevalence, and natural history of proliferative sickle cell retinopathy (PSR). Prospective longitudinal study over 20 years. Newborn screening of 100000 consecutive deliveries from 1973 to 1981 identified 315 children with homozygous sickle cell (SS) disease and 201 with SS-hemoglobin C (SC) disease. By the age of 5 years, 307 SS patients and 166 SC patients were alive and living in Jamaica and were recruited for this ophthalmic study. Description of retinal vascular changes on annual angiography and angioscopy. Incidence and prevalence of PSR and its behavior on follow-up. Progression of PSR was investigated using the number of eyes affected (none, one, both) and the interval until PSR onset. At last review in January 2000, PSR had developed in 59 patients (14 SS, 45 SC), unilaterally in 36 patients and bilaterally in 23. Incidence increased with age in both genotypes, with crude annual incidence rates of 0.5 cases (95% confidence interval [CI], 0.3-0.8)...
Treatment of iatrogenic choriovitreal neovascularization in sickle cell disease
British Journal of Ophthalmology, 1991
The effect of scatter photocoagulation on the perfusion of iatrogenic choriovitreal neovascularisation (CVN) has been assessed by a randomised trial in 35 CVN lesions in 18 eyes with proliferative sickle retinopathy. No difference in size or vascularity ofCVN lesions was apparent between the nine treated and nine control eyes over a median follow-up of42 months. Scatter photocoagulation by the stated protocol was not effective in the treatment of CVN. associated with rapid enlargement of the lesion,' vitreous haemorrhage, and traction detachment of the retina.2 In proliferative retinal vascular disease clinical evidence of a link between retinal ischaemia and retinal neovascularisation is well known. Hypotheses for the mechanism include the roles of retinal hypoxia, proteolytic enzymes on basement membrane collagen, insulin-like growth factors, and retina-derived growth factors.5 On the assumption that these influences induce and maintain the ingrowth of choroidal vessels the effect oflocal retinal ablation has been investigated.