How are nonproliferative retinal changes characterized in sickle cell disease (SCD)?

Updated: Jul 22, 2021
  • Author: Mark Ventocilla, OD, FAAO; Chief Editor: Andrew G Lee, MD  more...
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Nonproliferative or background sickle retinopathy includes the following manifestations:

  • Venous tortuosity

  • Salmon-patch hemorrhage

  • Schisis cavity

  • The black sunburst

Venous tortuosity probably is due to arteriovenous shunting from the retinal periphery. It can occur in many patients with hemoglobin SS and hemoglobin SC disease.

Salmon-patch hemorrhages are superficial intraretinal hemorrhages. They are usually seen in the mid periphery of the retina adjacent to a retinal arteriole.

The schisis cavity is a space caused by the disappearance of the intraretinal hemorrhage. Nonproliferative sickle retinopathy features iridescent spots and glistening refractive bodies in the schisis cavity.

The black sunburst consists of round chorioretinal scars usually located in the equatorial fundus. These lesions result from pigment accumulated around the vessels. They do not cause any visual symptoms.

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