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AbstractDO.01.12 Vasoproliferative retinopathy in sickle cell anemia: clinical course and complications Gabel-Pfisterer A.1, Krause L.1, Jandeck C.2, Bechrakis N. E.3, Foerster M. H.1
1Augenklinik, Klinikum Benjamin-Franklin, Charité, Berlin; 2Artemis-Zentren Frankfurt/Main / Dillenburg; 3LKH Innsbruck, Universitätsklinik für Augenheilkunde Objective: Up to 30 % of patients with sickle cell anemia develop a vasoocclusive and proliferative retinopathy. Due to migration the number of affected people seems to increase in Berlin. We report on the five patients with sickle cell anemia, who were treated in the department of ophthalmology of the Klinikum Benjamin-Franklin Charité Berlin and focus on visual function, therapy and complications.
Methods: Retrospectively, we analyse the development of visual acuities and the clinical course of therapy and complications. At every examination we have performed a snellen visual acuity, slit lamp examination and indirect ophthalmoscopy. If necessary, sonography or fluorescein angiography were perfomed.
Results: At initial examination in two of ten eyes a tractional retinal detachment and in two other eyes a vitreal hemorrhage was found. The initial visual acuity in these severely affected eyes was hand movement to 0,16 (median 0,1). After vitrectomy with SF6 or silicone oil endotamponade and a mean follow-up of 14 months the visual acuity ranged from 0,1 to 0,4 (median 0,16). In one eye three reoperations were necessary for stabilisation of the retina. All six other eyes were affected by a peripheral proliferative retinopathy, the visual acuity ranged from 0,5 to 1,25 (median 1,0). In all cases a panretinal lasercoagulation was performed. In one eye choroidal infarction emerged. Visual acuity at last follow-up was 0,5 to 1,0 (median 0,8). Note that in three out of five patients the diagnosis of retinopathy led to the diagnosis of sickle cell anemia.
Conclusions: Sickle cell retinopathy must be part of the differential diagnosis of vasoproliferative retinopathies. In peripheral retinal vasoproliferation lasercoagulation is indicated to prevent patients from severe complications and visual loss. Vitreoretinal surgery is necessary if vitreal hemorrhage and tractional retinal detachment should occur.
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