A review of outcomes of laser photocoagulation for Goldberg stage 3 proliferative sickle cell retinopathy
DOI:
https://doi.org/10.51496/jogm.v2.83Keywords:
sickle cell retinopathy, proliferative sickle cell retinopathy, sea fan neovascularization, laser photocoagulation, regression of sea fansAbstract
Topic: A review of outcomes of laser photocoagulation for Goldberg stage 3 proliferative sickle cell retinopathy (PSR) in a Eye Foundation Hospital.
Aims and objectives: To report regression of retina neovascularization and visual outcomes after prophylactic scatter retina laser photocoagulation for Goldberg stage 3 PSR in a tertiary private hospital in sub-Saharan Africa.
Methods: A retrospective review of case files of patients who were treated with prophylactic scatter retina laser photocoagulation between January 2017 and June 2022 following a diagnosis of PSR in a Eye Foundation Hospital, Ikeja, Lagos, Nigeria, was done.
Results: A total of 124 eyes of 62 patients with PSR were seen within the period under consideration. A majority of patients (49 (79.0%)) had hemoglobin (Hb) genotype SC, while 13 patients (21%) were Hb genotype SS. At presentation, 29 eyes (23.3%) had Goldberg stage 2 PSR, 55 eyes (44.4%) had Goldberg stage 3 PSR, 27 eyes (21.8%) had stage 4 PSR, while 13 eyes (10.5%) had stage 5 PSR. All 55 eyes (49.2%) with stage 3 PSR were treated with prophylactic retina laser photocoagulation. At the patients’ last clinic visit, 34 eyes (61.8%) had the same visual acuity (VA) as at presentation, 11 eyes (20%) had improvements in VA, while 10 eyes (18.2%) had worse VA. Laser treatment success (regression of seafan neovascularization) was seen in 50 eyes (90.9%), while five eyes (8.1%) had unsuccessful laser treatment.
Conclusion: A high percentage (90.9%) of resolution of retina neovascularization secondary to PSR at stage 3 of Goldberg’s classification was seen after prophylactic scatter retina laser photocoagulation in our group of evaluated patients. Most patients (81.8%) maintained or had improvements in their visual acuities over the period of follow-up. More clinical research is required to further evaluate outcomes of laser photocoagulation for PSR.
References
Myint KT, Sahoo S, Thein AW, Moe S, Ni H. Laser therapy for retinopathy in sickle cell disease. Cochrane Database Syst Rev 2015; 2015(10): CD010790. doi: 10.1002/14651858.CD010790.pub2 DOI: https://doi.org/10.1002/14651858.CD010790.pub2
World Health Organization (WHO). Sickle cell disease: a strategy for the WHO Africa region. Report of the regional director. Document number AFR/RC60/8. Geneva, Switzerland: World Health Organization, Regional Office for Africa; 2010.
Goldberg ME Classification and pathogenesis of proliferative sickle retinopathy. Am J Ophthalmol 1971; 71: 649–65. doi: 10.1016/0002-9394(71)90429-6 DOI: https://doi.org/10.1016/0002-9394(71)90429-6
Amissah-Arthur KN, Mensah E. The past, present and future management of sickle cell retinopathy within an African context. Eye 2018; 32(8): 1304–14. doi: 10.1038/s41433-018-0162-8 DOI: https://doi.org/10.1038/s41433-018-0162-8
GBD 2019 Blindness and Vision Impairment Collaborators; Vision Loss Expert Group of the Global Burden of Disease Study. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study. Lancet Glob Health 2021; 9(2): e144–60. doi: 10.1016/S2214-109X(20)30489-7 DOI: https://doi.org/10.1016/S2214-109X(20)30489-7
Jampol LM, Condon P, Farber M, Rabb M, Ford S, Serjeant G. A randomized clinical trial of feeder vessel photocoagulation of proliferative sickle cell retinopathy: I. Preliminary results. Ophthalmology 1983; 90(5): 540–5. doi: 10.1016/S0161-6420(83)34537-1 DOI: https://doi.org/10.1016/S0161-6420(83)34537-1
Farber MD, Jampol LM, Fox P, Moriarty BJ, Acheson RW, Rabb MF, et al. A randomized clinical trial of scatter photocoagulation of proliferative sickle cell retinopathy. Archiv Ophthalmol 1991; 109(3): 363–7. doi: 10.1001/archopht.1991.01080030065040 DOI: https://doi.org/10.1001/archopht.1991.01080030065040
Oluleye TS. Pattern of presentation of sickle cell retinopathy in Ibadan. J Clin Exp Ophthalmol 2012; 3: 257.
Hassan AO, Oderinlo O, Okonkwo ON. Pattern of presentation seen in sickle cell retinopathy patients in Eye Foundation Hospital Lagos. Niger J Ophthalmol 2005; 13(1): 17–20. doi: 10.4314/njo.v13i1.11961 DOI: https://doi.org/10.4314/njo.v13i1.11961
Hassan AO, Oderinlo O, Okonkwo ON. Visual outcome after laser photocoagulation for stage 4 proliferative sickle cell retinopathy. Niger J Ophthalmol 2004; 12(1): 19–22. doi: 10.4314/njo.v12i1.11940 DOI: https://doi.org/10.4314/njo.v12i1.11940
Rednam KR, Jampol LM, Goldberg MF. Scatter retinal photocoagulation for proliferative sickle cell retinopathy. Am J Ophthalmol 1982; 93(5): 594–9. doi: 10.1016/S0002-9394(14)77374-X DOI: https://doi.org/10.1016/S0002-9394(14)77374-X
Abdalla Elsayed MEA, Mura M, Al Dhibi H, Schellini S, Malik R, Kozak I, et al. Sickle cell retinopathy. A focused review. Graefes Arch Clin Exp Ophthalmol 2019; 257: 1353–64. doi: 10.1007/s00417-019-04294-2 DOI: https://doi.org/10.1007/s00417-019-04294-2
Sayag D, Binaghi M, Souied EH, Querques G, Galacteros F, Coscas G, et al. Retinal photocoagulation for proliferative sickle cell retinopathy: a prospective clinical trial with new sea fan classification. Eur J Ophthalmol 2008; 18(2): 248–54. doi: 10.1177/112067210801800213 DOI: https://doi.org/10.1177/112067210801800213
Dinah C, Greystoke B, Mueller I, Talks J. Action on sickle cell retinopathy: the time is now. Eye 2022; 36(6): 1138–9. doi: 10.1038/s41433-021-01918-y DOI: https://doi.org/10.1038/s41433-021-01918-y
Dormandy E, James J, Inusa B, Rees D. How many people have sickle cell disease in the UK? J Public Health 2018; 40: e291. doi: 10.1093/pubmed/fdx172 DOI: https://doi.org/10.1093/pubmed/fdx172
Salinas Cisneros G, Thein SL. Recent advances in the treatment of sickle cell disease. Front Physiol 2020; 11: 435. doi: 10.3389/fphys.2020.00435 DOI: https://doi.org/10.3389/fphys.2020.00435
Published
How to Cite
License
Copyright (c) 2022 Olufemi Oderinlo, Stanley Bulus, Victor Umeh, Lateefat Oshunkoya, Adekunle Hassan
This work is licensed under a Creative Commons Attribution 4.0 International License.
Journal of Global Medicine | Editor-in-Chief: Olufunso Adedeji. MBBS, MD, FRCSEd. 
