Central Macular Splaying and Outer Retinal Thinning in Asymptomatic Sickle Cell Patients by Spectral-Domain Optical Coherence Tomography

Purpose: We investigate the prevalence and degree of macular thinning on optical coherence tomography (SDOCT) in African American female patients with asymptomatic sickle cell disease. Design: Prospective comparative case series. Methods: Twenty one sickle cell patients (42 eyes) without other systemic or ocular diseases and 18 healthy control patients (33 eyes) underwent SDOCT. Images were manually segmented to measure inner retinal thickness (IRT) and outer retinal thickness (ORT). Central macula (central 1mm), parafoveal (0.5-1.5mm eccentricity), and perifoveal (1.5-3mm eccentricity) thickness measurements were obtained in sickle cell patients and age/gender/race-matched healthy control subjects. Results: Central macular total thickness (CMT) in sickle cell patients was 220 +/- 3μm (mean +/-SEM), which was significantly lower (p< 0.05) than controls (228 +/- 3μm). Parafoveal regions had thickness measurements of 314 +/- 5μm (nasal) and 304 +/- 2μm (temporal), which were significantly lower than controls (327 +/- 2μm and 311 +/- 2μm nasally and temporally, respectively) (p< 0.03, p< 0.043). There was also no significant difference in IRT in central macular, para- and perifoveal regions. Central macular ORT was 175 +/- 2μm versus 185 +/- 1μm in controls (p< 0.0002). ORT in temporal para- and perifoveal regions were 142 +/- 2μm and 120 +/-1μm, respectively versus 150 +/- 1μm and 122 +/- 1μm in controls (p< 0.001 and p=0.16, respectively). Conclusions: Manual segmentation of SDOCT images revealed significant total retinal thinning in the central macula and splaying in asymptomatic sickle cell patients. Retinal thinning was predominately in outer retinal layers in central macula and parafoveal regions.