Name
458 - Comparaison de l'angiographie ultra grand champ à l'angiographie traditionnelle dans la classification de la rétinopathie drépanocytaire proliférante

Merci de vous identifier pour accéder à ce contenu.

Je me connecte  


Orateurs :
Dr Audrey GIOCANTI
Auteurs :
Dr Audrey GIOCANTI
Dr Gwénola DROUGLAZET
Bahram Bodaghi
franck fajnkuchen
Tags :
Segment postérieur
rétine
Rétine
Congrès SFO 2019
2019
Résumé

Introduction

To date, there is no gold standard exam for the screening, classification and follow-up of sickle cell retinopathy. However, for diabetic retinopathy, the reference is the 7 EDTRS fields photographs. We performed a mono center observational cross-sectional study to compare ultra-wide field angiography to 7 ETDRS fields in patients presenting or screened for sickle cell retinopathy(SCR).

Patients et Methodes

59 eyes of 30 patients, who had underwent Ultra-wide-field (UWF) angiography (Optos ©, Optos Inc., Scotland) for screening or follow-up between September 2016 and April 2018, were included. Ultra-wide-field were interpreted and then another analysis was made by superimposing the ETDRS grid (software Optos ©) over the UWF retinography. The stage of sickle cell retinopathy was defined for each case using the Goldberg classification.

Résultats

After UWF images analysis, 96.6% of the eyes assessed had sickle cell retinopathy: 47.5% stage 2, and 49.1% stage 3. 52 eyes (88.1%) showed differences between the UWF and the ETDRS 7 snapshots.

Among these 52 images, 46.2% were qualified as stage 2 sickle cell retinopathy in UWF but normal in the 7 ETDRS fields and 32.7% were qualified as stage 3 in UWF but normal on the 7 ETDRS fields. Thus, 41 out of 59 (69.5%) of the cases had UWF (stage 2 or 3) sickle cell retinopathy that was  not diagnosed with the 7 ETDRS fields. 24 eyes categorized as "stage 3 retinopathy" in UWF (82.7%) were not diagnosed with ETDRS images.

Discussion

There is currently no consensus for the use of standard or UWF angiography in the screening, and classification of SCR. As well as in diabetic retinopathy, the earlier visualization of peripheral lesions could improve the prognosis of our patients. 

Conclusion

This study showed the clear superiority of the ultra-wide field imaging technique in the screening and classification of proliferative sickle cell retinopathy compared to the 7 ETDRS fields.