Unilateral macular infarction occurred in a 23-yearold black man with sickle cell hemoglobinopathy (SS), who was already receiving oxygen and hydration treatment for a painful crisis. Visual acuity of 20sol;200-1 in the affected eye did not improve with 36 hou rs of ldquo;conservativerdquo; treatment. Fifteen hours after an exchange transfusion, however, visual acuity started to improve. By 36 hours after transfusion, a visual acuity of 20sol;40 was achieved, with the gradual return over 8 weeks to 20sol;20. This case provides strong circumstantial support for the effectiveness of exchange transfusion in sickling maculopathy. RETINA 5colon;227-229, 1985
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