Retinal photocoagulation for proliferative sickle cell retinopathy: a prospective clinical trial with new sea fan classification.

PURPOSE: To compare the clinical outcome of stage III proliferative sickle cell retinopathy (PSR) treated by peripheral retinal scatter photocoagulation to natural course disease. METHODS: Long-term follow-up of 101 patients enrolled in a prospective trial of photocoagulation for PSR has been completed. Among 202 eyes of 101 patients enrolled at the University Eye Clinic of Créteil, 73 eyes showed a stage III PSR, which the authors further divided into five new grades (A, B, C, D, E) considering size, hemorrhage, fibrosis, and visible vessels. Grading was based on a three-mirror fundus examination, 360 degrees color photographs, and fluorescein angiography. Mean follow- up was 4 years. RESULTS: Thirty-eight treated eyes and 35 untreated eyes were included in this study. The evolution was not statistically significant between treated and untreated groups concerning flat sea fan <1 MPS disc area (grade A) or elevated sea fan with partial fibrosis (grade C). Progression and regression were compared between the two groups for grade B, resulting statistically significant (p<0.05). Nine complications (13%) were observed, which only occurred in untreated patients with elevated sea fan and hemorrhage (grade B) or complete fibrosed sea fan with well defined vessels (grade E) (p<0.05). CONCLUSIONS: These data suggest that patients with grade A or C new sea fan classification should not be initially treated but observed.

Serum zinc, copper and magnesium in sickle cell disease at Ibadan, south western Nigeria.

Serum zinc, copper and magnesium were studied in patients with sickle cell disease in the steady state. There was significantly lower serum zinc concentration (P < 0.01) and significantly higher serum copper and magnesium in haemoglobin S patients compared with controls (HbA). In haemoglobin SC patients, there was a significant reduction in serum zinc (P < 0.01) but no significant difference in serum copper and magnesium concentrations compared with the controls. There was no significant difference in serum zinc concentration between the HbS and HbS + C patients. However there were significantly higher serum copper and magnesium in HbS than HbS + C patients (P < 0.01) The level of serum zinc has no correlation with the steady state Haematocrit or severity index score in HbS and HbS + C patients.