Ophthalmic Manifestation of Sickle Cell Patients in Eastern India OC13-OC15
Dr. Srikant Kumar Dhar,
3/1, Annapurna Residensy, Mahatab Road, Old Town, Bhubaneswar-751002, Odisha, India.
Introduction: Sickle Cell Disease (SCD) is the most common and a serious form of an inherited blood disorder that leads to increased risk of early mortality and morbidity. Some of the ophthalmological complications of SCD include retinal changes, vitreous haemorrhage, and abnormalities of the conjunctiva. Irrecoverable Vision loss may be a manifestation if not diagnosed early and treated appropriately.
Aim: To determine different ophthalmic manifestations in SCD patients and correlate in relation to HbS window.
Materials and Methods: A total of 49 cases of sickle cell disease (HbSS) that presented to IMS & SUM Hospital were evaluated for ophthalmic manifestations in Ophthalmology OPD with comprehensive eye examination, slit lamp examination, Fundoscopy (Direct and Indirect) and OCT (Optical Coherence Tomography). Demographics and pattern of presentation were recorded in the proforma prepared for the study.
Results: Male:Female ratio was 3:1. About 2/3rd of the patients were below 40 years of age. Examination of posterior segment revealed 5 (10%) of the patients presented with proliferative retinopathy, 15 (30%) with non proliferative retinopathy, 13(26%) with optic disc changes, 7 (14%) with retinal macular changes and 2 (4%) had retinal detachment findings are significantly different at p=0.001 in ANOVA Test. Anterior segment of eye evaluation demonstrated significant (p=0.0001) changes 18 (36%) patients suffered conjunctival vascular changes, Cataract in 8(16%) patients, and hyphema in only 2 (4%) patients. Both anterior and posterior segment manifestations significantly (p=0.0027) increased with progressive increase in HbS window.
Conclusion: Sickle cell patients need periodic ophthalmic examinations to identify treatable lesions amenable to intervention and to prevent blindness. Both anterior and posterior segment manifestations increases with progressive increase in HbS window in HbSS patients.