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Abstract
Introduction. Sickle cell retinopathy (SCR) is the most prevalent and vision-threatening ocular manifestation of sickle cell disease (SCD). No studies had assessed its burden in Northern Cameroon. This study aimed to determine the prevalence and describe the clinical features of SCR in patients with SCD at Garoua Regional Hospital. Methods. A hospital-based, cross-sectional study was conducted over 13 months (May 2023 – May 2024) among SCD patients aged ≥ 5 years attending the ophthalmology outpatient clinic. Visual acuity testing and retinal examination using a three-mirror lens or indirect ophthalmoscopy were performed. SCR was classified using Goldberg's staging. Data were analyzed using SPSS version 27. Results. Forty-three patients (86 eyes) were enrolled (24 females, 55.8 %; mean age 12.42 ± 7.66 years). SCR was identified in 30.2 % (95 % CI: 16.5 – 44.0) of participants. All cases were non-proliferative. The most frequent lesions were venous tortuosity (53.8 %), perivascular sheathing (30.8 %), and salmon-patch hemorrhages (15.4 %). No significant associations were found between SCR and age or sex. Conclusion. In this Northern Cameroonian cohort, approximately one-third of SCD patients had SCR, predominantly non-proliferative. Regular retinal screening is crucial for early detection and management.
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References
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References
1. Amissah‑Arthur KN, Mensah E. The past, present and future management of sickle cell retinopathy within an African context. Eye (Lond). 2018;32(8):1304–1314.
2. Adrienne WS. Ophthalmic Manifestations of Sickle Cell Disease. South Med J. 2016;109(9):542–548.
3. Alshehri AM, Feroze KB, Amir MK. Awareness of ocular manifestations, complications and treatment of sickle cell disease in Saudi Arabia. Middle East Afr J Ophthalmol. 2019;26(2):89–94.
4. Li J, Bender L, Shaffer J, et al. Prevalence and Onset of Pediatric Sickle Cell Retinopathy. Ophthalmology. 2019;126(7):1000–1006.
5. Farid M, Barkat AK, Bushra U, Abder M. Sickle cell retinopathy: improving care with a multidisciplinary approach. J Multidiscip Healthc. 2017;10:335–346.
6. Xiangyun JD, Sophie L, Marguente OL, et al. Clinical and ophthalmic factors associated with the severity of sickle retinopathy. Am J Ophthalmol. 2019;197:105–113.
7. Alfred OK, Kahaki K, Dunera I, et al. Ocular manifestations of sickle cell disease at Korle‑Bu Hospital, Accra, Ghana. Eur J Ophthalmol. 2011;21(4):484–489.
8. Kéclard L, Romana M, Saint‑Martin C. Épidémiologie des gènes globines dans le bassin Caribéen. In: Drépanocytose: regards croisés sur une maladie orpheline. Paris: L’Harmattan; 2004. p. 75–94.
9. Fadugbagbe AO, Gurgel RQ, Mendonça CQ, et al. Ocular manifestations of sickle cell disease. Ann Trop Paediatr. 2010;30(1):19–26.
10. Abdalla EMEA, Mura M, Al Dhibi H, et al. Sickle cell retinopathy: a focused review. Graefes Arch Clin Exp Ophthalmol. 2019;257(7):1353–1364.
11. Jing J, Robinn M, Jonathan S, et al. Funduscopic examination and SD‑OCT in detecting sickle cell retinopathy among pediatric patients. J AAPOS. 2018;22(3):197–201.e1.
12. Dembélé AK, Toure BA, Sarro YS, et al. Prevalence and risk factors for sickle retinopathy in a sub‑Saharan comprehensive Sickle Cell Center. Rev Med Interne. 2017;38(9):572–577.
13. Dohvoma VA, Ebana MS, Epee E, et al. Prévalence de la rétinopathie drépanocytaire chez les homozygotes SS à Yaoundé. Health Sci Dis. 2021;22(4).
14. Goldberg MF. Classification and pathogenesis of proliferative sickle retinopathy. Am J Ophthalmol. 1971;71(3):649–665.
15. Tantawy AA, Andrawes NG, Adly AA, et al. Retinal changes in children and adolescents with SCD in Cairo: risk factors and relation to ocular/cerebral blood flow. Trans R Soc Trop Med Hyg. 2013.
16. Tamer H, Mohamed B, Diana H, et al. Retinopathy in Egyptian patients with SCD: a cross‑sectional study. Medicine (Baltimore). 2021;100(51):e28355.
17. Saadouli D, Yahyaoui S, Ben Issa S, et al. La rétinopathie drépanocytaire chez l’enfant: à propos de 42 cas. J Fr Ophtalmol. 2020;43(4):319–323.
18. Oluwatoyin IO, Oluwuagbemiga OA, Oluwatoyin HO, Samuel AA. Prevalence of ocular abnormalities and SCD severity among children in southwestern Nigeria. Eur J Ophthalmol. 2021;31(5):2659–2665.
19. Bilong Y, Dubert M, Koki G, et al. Sickle cell retinopathy and other chronic complications of sickle cell anemia: a clinical study of 84 cases in Cameroon. J Fr Ophtalmol. 2018;41(1):50–56.
20. De Almeida ODC, Carvalho MO, Do Nascimento VM. SCD retinopathy among pediatric/teenage patients in Northern Brazil. Rev Bras Hematol Hemoter. 2014;36(5):340–344.
21. Rosenberg JB, Hutcheson KA. Pediatric SCD retinopathy: correlation with clinical factors. J AAPOS. 2011;15(1):49–53.
22. Epoh M, Nzokou M, Nomo N, et al. Rétinopathie drépanocytaire à l’Hôpital Général de Douala: aspects épidémiologiques et cliniques. Health Sci Dis. 2018;19(4 Suppl 1).