• Written By:
    Pediatric Ophth/Strabismus

    This study compares the ability of fundus exams and spectral domain OCT (SD-OCT) to detect retinal changes in children with sickle cell disease (SCD).

    Study design

    The single-center prospective study included 69 consecutive African American children (age 5–20) with SCD. Patients were divided into 4 phenotypes: SS, SC, Sβ+ and Sβ0. Each child underwent a complete ophthalmic examination, and bilateral SD-OCT imaging of the macula.

    Outcomes

    On average, SD-OCT diagnosed retinopathy 1.78 years earlier than fundus examination (P=0.0087). Of the 22 patients under 10 years of age, more than 50% had detectable change on SD-OCT.

    On average, SC patients demonstrated retinal change 0.7 years earlier than the SS/Sβ0 group, regardless of detection modality. While SC patients were more frequently diagnosed retinopathy by conventional fundoscopic examination, retinal thinning by SD-OCT was more severe in SS/Sβ0.

    Limitations

    SD-OCT has a limited scanning area and peripheral findings could be missed. Young children may not be able to cooperate with peripheral retinal examination or SD-OCT imaging.

    Clinical significance

    It is important to use SD-OCT in conjunction with a complete ophthalmologic examination when evaluating for retinopathy in children with SCD. Physicians should consider screening children with SCD prior to age 10.