Proliferative sickle cell retinopathy (PSR) can lead to visual loss from vitreous haemorrhage and traction or rhegmatogenous retinal detachment. We review two techniques of photocoagulation for PSR, feeder vessel photocoagulation and scatter photocoagulation. A prospective randomised trial of feeder vessel photocoagulation for PSR demonstrated that the incidence of vitreous haemorrhage and visual loss was diminished in eyes which were treated. Since this technique of treatment is difficult and can be associated with choroidal neovascularisation and retinal tears, scatter photocoagulation has also been tested. A prospective randomised trial of scatter photocoagulation for PSR demonstrated a decreased incidence of vitreous haemorrhage and visual loss in treated eyes compared to untreated eyes. No complications of scatter treatment were noted.
We presently recommend local scatter photocoagulation to areas of PSR. In unreliable patients, we recommend 360 degrees of peripheral circumferential treatment as otherwise new seafans will develop. If scatter photocoagulation does not result in sufficient regression of the neovascularisation and vision threatening complications such as vitreous haemorrhage continue, feeder vessel treatment can be used to supplement the scatter treatment.
Moriarty BJ, Acheson RW, Condon PI, Serjeant GR : Patterns of visual loss in untreated sickle cell retinopathy. Eye 1988. 2: 330–5.
Jampol LM, Condon P, Farber M, Rabb M, Ford S, Serjeant G : A randomised clinical trial of feeder vessel photocoagulation of proliferative sickle cell retinopathy: I Preliminary results. Ophthalmology 1984. 90: 450-5.
Condon P, Jampol LM, Farber MD, Rabb M, Serjeant G : A randomised clinical trial of feeder vessel photocoagulation of proliferative sickle cell retinopathy: II Update and analysis of risk factors. Ophthalmology 1984, 91: 1496-8.
Jacobson MS, Gagliano DA, Cohen SB, Rabb MF, Jampol LM, Farber MD, Goldberg MF : A randomised clinical trial of feeder vessel photocoagulation of sickle cell retinopathy: A long-term follow-up Ophthalmology (In press).
Farber MD, Jampol LM, Fox P, Moriarty BJ, Ache-son RW, Rabb MF, Serjeant GR : A randomised clinical trial of scatter photocoagulation of proliferative sickle cell retinopathy. Arch Ophthalmol (In Press), publication.
Goldberg MF and Jampol LM . Treatment of neovascularization, vitreous haemorrhage, and retinal detachment in sickle cell retinopathy. In Symposium on Medical and Surgical Diseases of the Retina and Vitreous. St. Louis CV Mosby 1983; 53-81.
Dizon-Moore RV, Jampol LM, Goldberg MF : Chorioretinal and choriovitreal neovascularization: Their presence after photocoagulation of proliferative sickle retinopathy. Arch Ophthalmol 1981. 99: 842-9.
Carney MD, Paylor RR, Cunha-Vaz JG, Jampol LM, Goldberg MF : Iatrogenic choroidal neovascularization in sickle cell retinopathy. Ophthalmology 1986. 93: 1163-8.
Jampol LM and Goldberg MF : Retinal breaks after photocoagulation of proliferative sickle cell retinopathy. Arch Ophthalmol 1980. 98: 676-9.
Rednam KRV, Jampol LM, Goldberg MF : Scatter retinal photocoagulation for proliferative sickle cell retinopathy. Am J Ophthalmol 1982. 93: 594-9.
Cruess AF, Stephens RF, Magargal LE, Brown GC : Peripheral circumferential retinal scatter photo-coagulation for treatment of proliferative sickle retinopathy. Ophthalmology 1983 90: 272-8.
Kimmel AS, Magargal LE, Stephens RF, Cruess AF : Peripheral circumferential retinal scatter photocoagulation for the treatment of proliferative sickle retinopathy. An update. Ophthalmology 1986. 93: 1429-34.
Supported in part by PHS Grant #HL15168 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland and by an unrestricted grant from Research to Prevent Blindness, Inc., New York City.
About this article
Cite this article
Jampol, L., Farber, M., Rabb, M. et al. An update on techniques of photocoagulation treatment of proliferative sickle cell retinopathy. Eye 5, 260–263 (1991). https://doi.org/10.1038/eye.1991.41
- sea fan
- proliferative sickle cell retinopathy
- xenon arc
- scatter photocoagulation
- feeder vessel photocoagulation