RESUMO
We have conducted screening programmes at King's College Hospital for the assessment of the ocular manifestations of sickle cell disease in adults as well as in children. We have followed the same protocol used in the cohort study carried out in Jamaica. Fundus flourescein angiograms were performed on patients over the age of five. Our findings were compared to those of the Jamaican cohort. The studies were agreed by the Medical ethical committee at King's College Hospital. Some of the results have already been published. We have also documented some cases of retionopathy in patiens with AS and AC haemoglobinopathy. The eye is an invaluable window that provides an opportunity to assess the presence and progression of small vessel disease. The ocular manifestations of sickle cell haemoglobinopathies provide useful clues to the understanding of this condition. I propose to present a summary of our results so far. This study was supported by the locally organized research scheme and was conducted in association with Professor Alastair Bellingham and Dr. Arya from the Haemotology department at King's College Hospital and Professor A C Bird from Moorfields eye Hospital.(AU)
Assuntos
Criança , Humanos , Estudo Comparativo , Anemia Falciforme/diagnóstico , Anemia Falciforme/epidemiologia , Hemoglobinopatias , Olho , Fluorofotometria , Inglaterra , JamaicaRESUMO
There are marked variations in the manifestations of sickle disease in different populations. The ocular complications of this condition amongst the Afro-Caribbeans living in the United Kingdom have not previously been reported. We present the preliminary results of an ophthalmic screening programme at King's College Hospital, London. One hundred eyes of 50 patients with sickle cell disease were assessed. Full ocular examination was performed including fundus fluorescein angiography. We have looked at the haematological and clinical profile of the patients involved as well as the number of days spent in hospital during the year preceding the eye examination. The incidence of grade II retinopathy was found to be significantly higher than grade I in SC disease. This concurs with the results of the Jamaican screening and confirms that these patients are at higher risk of visual impairment than those with SS disease. Our results also agree with the Jamaican experience which suggest that visual morbidity is mostly due to complications of proliferative sickle retinopathy (PSR). However, the findings in patients without proliferative changes are different; in particular, angioid streaks leading to disciforms are an important cause of visual loss in Jamaica, but were not seen in any of the 98 eyes examined in this study. No correlation was found between the grade of retinopathy and age, sex, systemic complications and various haematological parameters except for the percentage of haemoglobin F, which was significantly higher in patients with grade I (7.6) compared with grade II (4.2) retinopathy (p = 0.0127).
Assuntos
Doenças Retinianas/epidemiologia , Traço Falciforme/complicações , Adolescente , Adulto , África/etnologia , Feminino , Hemoglobina Fetal/análise , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Doenças Retinianas/etiologia , Doenças Retinianas/patologia , Vasos Retinianos/patologia , Traço Falciforme/sangue , Reino Unido/epidemiologia , Acuidade Visual , Índias Ocidentais/etnologiaRESUMO
There are marked variations in the manifestations of sickle cell disease in different populations. The occular complications of this condition amongst the Afro-Caribbeans living in the United Kingdom have not previously been reported. We present the preliminary results of an opthalmic screening programme at King's College Hospital, London. One hundred eyes of 50 patients with sickle cell disease were assessed. Full ocular examination was performed including fundus fluorescein angiography. We have looked at the haemotological and clinical profile of the patients involved as well as the number of days spent in the hospital during the year preceding the examination. The incidence of Grade 11 retinopathy was found to be significantly higher than grade 1 in SC disease. This concurs with the results of the Jamaican screening and confirms that the patients are at higher risk of visual impairment than those wuth the SS disease. Our results also agrees with the Jamaican experience which suggests that visual morbidity is mostly due to complications of proliferative sickle cell retinopathy (PSR). However, the findings in patients without proliferative changes are different; in particular, angloid streaks leading to disciforms are an important cause of visual loss in Jamaica, but were not seen in any of the 98 eyes examined in this study. No correlation was found between the grade of retinopathy and age, sex, systemic complications and various haematological parameters except for the percentage of haemoglobin F, which was significantly higher in patients with grade I (7.6) compared with grade II (4.2) retinopathy (p=0.0127)(AU)