Hemoglobin level and macular thinning in sickle cell disease

S Amal Hussnain,1–4 Patrick A Coady,1,5 Martin D Slade,6 Judith Carbonella,7 Farzana Pashankar,7 Ron A Adelman,1 Kathleen M Stoessel11Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA; 2Department of Ophthalmology, Columbia University Va...

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Autores principales:	Hussnain SA, Coady PA, Slade MD, Carbonella J, Pashankar F, Adelman RA, Stoessel KM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Sickle cell retinopathy macular thinning spectral-domain optical coherence tomography hemoglobin Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/9e9c91cbc0f2458e8fc534dd9aa925d7
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spelling	oai:doaj.org-article:9e9c91cbc0f2458e8fc534dd9aa925d72021-12-02T06:01:59ZHemoglobin level and macular thinning in sickle cell disease1177-5483https://doaj.org/article/9e9c91cbc0f2458e8fc534dd9aa925d72019-04-01T00:00:00Zhttps://www.dovepress.com/hemoglobin-level-and-macular-thinning-in-sickle-cell-disease-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483S Amal Hussnain,1–4 Patrick A Coady,1,5 Martin D Slade,6 Judith Carbonella,7 Farzana Pashankar,7 Ron A Adelman,1 Kathleen M Stoessel11Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA; 2Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; 3Vitreous Retina Macula Consultants of New York, New York, NY, USA; 4Department of Ophthalmology, New York University School of Medicine, New York, NY, USA; 5New England Retina Associates, Hamden, CT, USA; 6Department of Internal Medicine, Yale University School of Medicine and Yale School of Public Health, New Haven, CT, USA; 7Department of Pediatric Hematology and Oncology, Yale University School of Medicine, New Haven, CT, USAPurpose: To study the relationship between complete blood count (CBC) indices over time, particularly serum hemoglobin (Hb) levels, and severity of macular thinning on spectral domain optical coherence tomography (SD-OCT) in patients with sickle cell disease (SCD).Methods: This is a single-center, retrospective analysis of 141 consecutive SCD patients over a 10-year period, of which 40 patients (79 eyes) had SD-OCT imaging of the macula and 29 (58 eyes, mean age 17.5 years) were eligible for the study. Investigators reviewed electronic medical records for documentation of retinopathy stage, disease genotype, CBC values, and SD-OCT imaging. SD-OCT parameters and CBC values were compared between different retinopathy stages and disease genotypes. Regression analyses were performed on SD-OCT parameters and CBC values.Results: Of the 58 eligible eyes (34HbSS, 18HbSC, 4HbSβ +thal, 2HbS βthal), 18 had PSR (proliferative sickle retinopathy), 14 had NPSR (nonproliferative sickle retinopathy), and 26 had NSR (no sickle retinopathy). Hb values were higher in SC group compared to SS group. Macular thickness in the temporal inner (Δ=26±33 um, p=0.01) and outer (Δ=21±30 um, p=0.02) subfields was higher in SC compared to SS group. Patients with SD-OCT thinning below the 5th percentile in the temporal outer subfields had lower recorded Hb nadirs (6.0±0.9) compared to those with thickness within the top 95th percentile (9.1±2.3). Regression analysis showed temporal macular thickness to be positively correlated with Hb values in the SS group.Conclusion: Macular thinning observed on SD-OCT in SCD patients with SS genotype may be related to the level of anemia in this population.Keywords: sickle cell retinopathy, macular thinning, spectraldomain optical coherence tomography, hemoglobinHussnain SACoady PASlade MDCarbonella JPashankar FAdelman RAStoessel KMDove Medical PressarticleSickle cell retinopathymacular thinningspectral-domain optical coherence tomographyhemoglobinOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 627-632 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sickle cell retinopathy macular thinning spectral-domain optical coherence tomography hemoglobin Ophthalmology RE1-994
spellingShingle	Sickle cell retinopathy macular thinning spectral-domain optical coherence tomography hemoglobin Ophthalmology RE1-994 Hussnain SA Coady PA Slade MD Carbonella J Pashankar F Adelman RA Stoessel KM Hemoglobin level and macular thinning in sickle cell disease
description	S Amal Hussnain,1–4 Patrick A Coady,1,5 Martin D Slade,6 Judith Carbonella,7 Farzana Pashankar,7 Ron A Adelman,1 Kathleen M Stoessel11Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA; 2Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; 3Vitreous Retina Macula Consultants of New York, New York, NY, USA; 4Department of Ophthalmology, New York University School of Medicine, New York, NY, USA; 5New England Retina Associates, Hamden, CT, USA; 6Department of Internal Medicine, Yale University School of Medicine and Yale School of Public Health, New Haven, CT, USA; 7Department of Pediatric Hematology and Oncology, Yale University School of Medicine, New Haven, CT, USAPurpose: To study the relationship between complete blood count (CBC) indices over time, particularly serum hemoglobin (Hb) levels, and severity of macular thinning on spectral domain optical coherence tomography (SD-OCT) in patients with sickle cell disease (SCD).Methods: This is a single-center, retrospective analysis of 141 consecutive SCD patients over a 10-year period, of which 40 patients (79 eyes) had SD-OCT imaging of the macula and 29 (58 eyes, mean age 17.5 years) were eligible for the study. Investigators reviewed electronic medical records for documentation of retinopathy stage, disease genotype, CBC values, and SD-OCT imaging. SD-OCT parameters and CBC values were compared between different retinopathy stages and disease genotypes. Regression analyses were performed on SD-OCT parameters and CBC values.Results: Of the 58 eligible eyes (34HbSS, 18HbSC, 4HbSβ +thal, 2HbS βthal), 18 had PSR (proliferative sickle retinopathy), 14 had NPSR (nonproliferative sickle retinopathy), and 26 had NSR (no sickle retinopathy). Hb values were higher in SC group compared to SS group. Macular thickness in the temporal inner (Δ=26±33 um, p=0.01) and outer (Δ=21±30 um, p=0.02) subfields was higher in SC compared to SS group. Patients with SD-OCT thinning below the 5th percentile in the temporal outer subfields had lower recorded Hb nadirs (6.0±0.9) compared to those with thickness within the top 95th percentile (9.1±2.3). Regression analysis showed temporal macular thickness to be positively correlated with Hb values in the SS group.Conclusion: Macular thinning observed on SD-OCT in SCD patients with SS genotype may be related to the level of anemia in this population.Keywords: sickle cell retinopathy, macular thinning, spectraldomain optical coherence tomography, hemoglobin
format	article
author	Hussnain SA Coady PA Slade MD Carbonella J Pashankar F Adelman RA Stoessel KM
author_facet	Hussnain SA Coady PA Slade MD Carbonella J Pashankar F Adelman RA Stoessel KM
author_sort	Hussnain SA
title	Hemoglobin level and macular thinning in sickle cell disease
title_short	Hemoglobin level and macular thinning in sickle cell disease
title_full	Hemoglobin level and macular thinning in sickle cell disease
title_fullStr	Hemoglobin level and macular thinning in sickle cell disease
title_full_unstemmed	Hemoglobin level and macular thinning in sickle cell disease
title_sort	hemoglobin level and macular thinning in sickle cell disease
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/9e9c91cbc0f2458e8fc534dd9aa925d7
work_keys_str_mv	AT hussnainsa hemoglobinlevelandmacularthinninginsicklecelldisease AT coadypa hemoglobinlevelandmacularthinninginsicklecelldisease AT slademd hemoglobinlevelandmacularthinninginsicklecelldisease AT carbonellaj hemoglobinlevelandmacularthinninginsicklecelldisease AT pashankarf hemoglobinlevelandmacularthinninginsicklecelldisease AT adelmanra hemoglobinlevelandmacularthinninginsicklecelldisease AT stoesselkm hemoglobinlevelandmacularthinninginsicklecelldisease
_version_	1718400124103688192

Hemoglobin level and macular thinning in sickle cell disease

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