History/Chief Complaint
- A 27-year-old black female presented for a retinal consult. She had previously been diagnosed with sickle cell SC disease, but was lost to follow-up for one year. The patient was completely asymptomatic both visually and systemically.
Clinical Findings
- BCVA 20/20 OU
- Rx: -1.25 sph OD -1.25 sph OS
- IOP: 14 OD 14 OS
- Fundus exam: Probable mild tortuous vessels OD>OS; otherwise an unremarkable appearance of the posterior pole. The peripheral retina when viewed with BIO revealed several black sunburst lesions as well as several zones of apparent fibroglial tissue.
Optos®
- Optomap® images revealed multiple abnormalities in the periphery of both eyes.
- A sunburst lesion and a zone of proliferative fibroglial tissue with possible surface neovascularization were noted in the temporal periphery of the right eye.
- Multiple sunburst lesions and two zones of probable fibroglial tissue were noted in the temporal periphery of the left eye as well.
- Optos® Fluorescein Angiography (FA) revealed multiple areas of leakage in the temporal periphery in both eyes and dramatic zones of capillary nonperfusion.
Diagnosis
- Proliferative sickle cell retinopathy OU.
Disposition
- The first of at least several scattered sectoral photocoagulation laser treatments was recommended and performed in each eye. The importance of careful follow-up was stressed to the patient.