SICKLE CELL RETINOPATHY

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Occlusion of small blood vessels in the eye, retinal neovascularization and its consequences occur in high frequency in patients with sickle cell disease. Neovascular seafans arise at the interface of perfused and nonperfused portions of the retina. Although some lesions undergo spontaneous autoinfarction, most show progressivegrowth, resulting in vitreous hemorrhage and retinal detachment. The emergence ofneovascolarization is stimulated by the production of vascular growth factors and immunoreactivity for these factors is greater within neovascularization than in adjacentretina and in non perfused peripheral retina. All these lesions can be observed directlywith an ophthalmoscope and indirectly with fluorescein angiography. The differentialdiagnosis of the neovascularization with other ischemic and inflammatory diseases isnecessary. The usual goal of management is the early treatment of stage III lesionswith laser photocoagulation and cryotherapy; pars plana vitrectomy or scleral bucklingare avoided unless it is absolutely necessary.
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