SMARTQCSurgical Outcomes of Retinal Detachment Associated with Proliferative Sickle Cell Retinopathy

Abstract

To evaluate the long-term anatomic and visual outcomes in eyes with sickle cell retinopathy (SCR)-related retinal detachments (RDs). Patients who underwent surgery for SCR-related RDs at the Wilmer Eye Institute or Wills Eye Hospital between 2008 and 2020 and followed for at least 6 months post-operatively were retrospectively reviewed. The primary outcome was the rate of single surgery anatomic success (SSAS) and final reattachment. This study included 30 eyes from 28 patients (16 female and 12 male) with tractional RD (TRD) (n=13), rhegmatogenous RD (RRD) (n=1), and combined TRD/RRD (n=16). Mean age was 42.1 ± 15.1 years. Mean follow-up duration was 47.8 ± 34.1 months. Twenty-five (83.3%) eyes underwent pars plana vitrectomy (PPV) and 5 (16.7%) eyes underwent PPV with scleral buckle (SB). SSAS was achieved in 21 (70.0%) eyes at 1 year. Final reattachment was achieved in 28 (93.3%) eyes (22 eyes [73.3%] without tamponade). Recurrence of RDs was significantly associated with male gender (P=0.041), absence of previous laser (P= 0.032), iatrogenic breaks (P=0.035), retinectomy (P=0.034), and SO tamponade (OR 7.857, P= 0.024). Overall, the logarithm of the minimum angle of resolution (logMAR) visual acuity improved from 1.53 ± 0.57 (Snellen equivalent, 20/678) to 1.15 ± 1.01 (20/283) at final visit (p = 0.03); however, eyes with recurrent RD did not achieve significant visual improvement. PPV to repair SCR-related RDs was effective in achieving anatomic success and improving vision in most eyes. SSAS is critical for optimizing visual outcomes.