First Author: M.Hood USA
Co Author(s): J. Calzada E. Sigler P. Brennen 0 0 0 0 0 0 0 0 0
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To evaluate the association between localized inner macular atrophy on optical coherence tomography (SD-OCT) and the presence of neovascularization in patients with sickle cell retinopathy.
The Charles Retina Institute in Memphis, Tennessee, USA.
All of the patients with a known diagnosis of sickle cell disease who had undergone macular SD-OCT and wide-field angiography at the Charles Retina Institute in Memphis, TN were reviewed. All eyes with prior macular pathology were excluded from this study. 40 eyes from 24 patients met inclusion criteria. The macular SD-OCT images were evaluated for the presence of localized inner macular atrophy, as defined by the presence of localized marked macular thinning of the inner retinal layers and/or localized obliteration of the macular inner nuclear layer. The most advanced stage of sickle cell retinopathy (SCR) in the patients at or prior to the acquisition of the SD-OCT was also recorded. The findings from SD-OCT were then compared to the stage of SCR.
Of the 40 eyes included in this study, at or prior to the acquisition of the SD-OCT, 2 eyes had stage I SCR, 1 had stage 2, 33 had stage III, 3 had stage IV, and 1 had stage 5. 15 of the 40 eyes displayed localized inner macular atrophy on SD-OCT. Of the eyes with localized inner macular atrophy, 1 was stage I SCR, 1 was stage II, 10 were stage III, 2 were stage IV, and 1 was stage V. The presence of localized inner macular atrophy had a sensitivity of 35%, specificity of 33%, positive predictive value of 87%, and negative predictive value of 4% for stage III or worse SCR. In addition, eyes with localized inner macular atrophy had a sensitivity of 75%, specificity of 67%, positive predictive value of 20%, and negative predictive value of 96% for stage IV or worse SCR.
The presence of localized inner macular atrophy has a high positive predictive value for stage III or worse SCR and a high negative predictive value for stage IV or worse SCR.