SCREENING FOR OPHTHALMIC MANIFESTATIONS OF SICKLE-CELL DISEASE IN THEUNITED-KINGDOM

There are marked variations in the manifestations of sickle disease in different populations. The ocular complications of this condition amo ngst the Afro-Caribbeans living in the United Kingdom have not previou sly been reported. We present the preliminary results of an ophthalmic screening programme at King's College Hospital, London. One hundred e yes of 50 patients with sickle cell disease were assessed. Full ocular examination was performed including fundus fluorescein angiography. W e have looked at the haematological and clinical profile of the patien ts involved as well as the number of days spent in hospital during the year preceding the eye examination. The incidence of grade II retinop athy was found to be significantly higher than grade I in SC disease. This concurs with the results of the Jamaican screening and confirms t hat these patients are at higher risk of visual impairment than those with SS disease. Our results also agree with the Jamaican experience w hich suggest that visual morbidity is mostly due to complications of p roliferative sickle retinopathy (PSR). However, the findings in patien ts without proliferative changes are different; in particular, angioid streaks leading to disciforms are an important cause of visual loss i n Jamaica, but were not seen in any of the 98 eyes examined in this st udy. No correlation was found between the grade of retinopathy and age , sex, systemic complications and various haematological parameters ex cept for the percentage of haemoglobin F, which was significantly high er in patients with grade I (7.6) compared with grade II (4.2) retinop athy (p = 0.0127).