[Screening for sickle cell disease retinopathy in the north of France]

Sickle cell retinopathy: improving care with a multidisciplinary approach

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 effect of LPC alone does not significantly lead to the regression of advanced SCR, although it helps in avoiding hemorrhage and sight loss. This comprehensive article is based on 10-years retrospective (2007–2017) studies. It aims to present advances and recommendations in SCR theranostics while pointing out the requirement of combinatorial approaches for better management of SCR patients. To reach this goal, we identified and analyzed randomized original and review articles, clinical trials, non-randomized intervention studies, and observational studies using specified keywords in various databases (eg, Medline, Embase, Cochrane, ClinicalTrials.gov).

[Proliferative sickle cell retinopathy revealing Glanzmann thrombasthenia]

Glanzmann thrombasthenia is a rare qualitative platelet abnormality of autosomal recessive transmission caused by absence of GP IIb/IIIa and resulting in disturbance of platelet aggregation and bleeding time extension. We report the case of a 16-year-old female suffering from SC sickle cell disease and presenting with bilateral vitreous hemorrhage revealing Glanzmann thrombasthenia. Despite vitrectomy, the functional prognosis was poor. Indeed, association of a severe hemorrhagic disease and sickle cell retinopathy makes surgical management difficult.