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JAMA Ophthalmology Clinical Challenge
September 3, 2020

Presumed Sickle Cell Retinopathy in an Elderly Woman

Author Affiliations
  • 1The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania
JAMA Ophthalmol. Published online September 3, 2020. doi:10.1001/jamaophthalmol.2020.1614

A 60-year-old African American woman presented with a 1-day history of new floaters in her right eye. She had no relevant medical history, was not taking any systemic or ocular medications, and denied a history of floaters. Her visual acuity was 20/40 OU, and her intraocular pressure was 18 mm Hg OU. An anterior segment examination was unremarkable in both eyes. Ophthalmoscopy findings were notable for a vitreous hemorrhage in the right eye. Salmon-patch intraretinal hemorrhages were noted in the temporal peripheral retina of both eyes (Figure 1). Widefield fluorescein angiography revealed retinal capillary nonperfusion of the peripheral retina with neovascularization elsewhere, in a sea fan–like pattern, in both eyes. The patient denied any known history of sickle cell disease or trait and any family history of sickle disease. Scatter laser photocoagulation was performed on the nonperfused temporal retina in the right eye, and the left eye was observed.

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