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.