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Sickle cell retinopathy: improving care with a multidisciplinary approach

机译:镰状细胞性视网膜病:采用多学科方法改善护理

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Sickle cell retinopathy (SCR) is the most representative ophthalmologic complication of sickle cell disease (SCD), a hemoglobinopathy affecting both adults and children. SCR presents a wide spectrum of manifestations and may even lead to irreversible vision loss if not properly diagnosed and treated at the earliest. Over the past decade, multidisciplinary research developments have focused upon systemic, genetic, and ocular risk factors of SCR, enabling the clinician to better diagnose and manage these patients. In addition, newer imaging and testing modalities, such as spectral domain-optical coherence tomography angiography, have resulted in the detection of subclinical retinopathy related to SCD. Innovative therapy includes intravitreal injection of an anti-vascular endothelial growth factor (eg, Lucentis® [ranibizumab] or Eylea® [aflibercept]) which appears comparatively safe and efficient, and may be combined with laser photocoagulation (LPC) for proliferative SCR. The effect of LPC alone does not significantly lead to the regression of advanced SCR, although it helps in avoiding hemorrhage and sight loss. This comprehensive article is based on 10-years retrospective (2007–2017) studies. It aims to present advances and recommendations in SCR theranostics while pointing out the requirement of combinatorial approaches for better management of SCR patients. To reach this goal, we identified and analyzed randomized original and review articles, clinical trials, non-randomized intervention studies, and observational studies using specified keywords in various databases (eg, Medline, Embase, Cochrane, ).
机译:镰状细胞性视网膜病(SCR)是镰状细胞病(SCD)的最典型的眼科并发症,镰状细胞性视网膜病是一种影响成人和儿童的血红蛋白病。 SCR表现出广泛的表现,如果不及早诊断和治疗,甚至可能导致不可逆的视力丧失。在过去的十年中,多学科研究发展集中于SCR的系统,遗传和眼部危险因素,使临床医生能够更好地诊断和管理这些患者。另外,较新的成像和测试方式,例如光谱域光学相干断层扫描血管造影,已导致发现与SCD相关的亚临床视网膜病变。创新疗法包括玻璃体腔注射抗血管内皮生长因子(例如,Lucentis ® [ranibizumab]或Eylea ® [aflibercept]),这种药物看来相对安全有效。可以与激光光凝(LPC)结合用于增生SCR。尽管LPC的作用有助于避免出血和视力丧失,但其单独作用并不会显着导致晚期SCR的消退。这篇全面的文章基于10年回顾性研究(2007-2017)。它旨在介绍SCR治疗学的进展和建议,同时指出更好地管理SCR患者的组合方法的要求。为了实现此目标,我们使用各种数据库(例如Medline,Embase,Cochrane等)中的指定关键字,确定并分析了随机的原始和评论文章,临床试验,非随机干预研究和观察性研究。

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