Central macular thickness in patients with sickle cell disease and no signs of retinopathy: a cross-sectional study of Jordanian patients.

OBJECTIVES: To measure central macular thickness in Jordanian patients with sickle cell disease who did not have retinopathy and compare the findings with age- and sex-matched controls using spectral domain optical coherence tomography (SDOCT). METHODS: In this cross-sectional study, participants underwent visual acuity testing, slit-lamp bio-microscopy, dilated ophthalmoscopy, and SDOCT imaging to measure central macular thickness. Macular quadrant measurements and thickness difference indexes (TDIs) were compared between groups. RESULTS: Twenty eyes with sickle cell disease and 20 control eyes were enrolled. The median visual acuity in both groups was 20/20. The mean macular thickness was significantly lower in eyes with sickle cell disease than in matched controls (mean difference, 22.15 ± 6.44 µm). Peripheral quadrants were all significantly thinner in eyes with sickle cell disease, especially in superior and temporal quadrants. TDIs were lower in eyes with sickle cell disease than in control eyes. CONCLUSIONS: Eyes with sickle cell disease that had no clinical evidence of retinopathy exhibited significantly lower central macular thickness in all quadrants, compared with eyes in age- and sex-matched controls. SDOCT is a non-invasive imaging modality that can detect preclinical changes in eyes with sickle cell disease and can be used to screen and monitor the disease process.

KeraRing intrastromal corneal ring segments for correction of keratoconus.

PURPOSE: Intrastromal corneal ring segments (ICRSs) are small arc-like implants that are being used increasingly as a minimally invasive treatment for patients with keratoconus. This study assessed the effectiveness of KeraRing implants, a type of ICRS, to treat keratoconus. METHODS: Retrospective case series descriptive study of 43 patients (55 eyes) with keratoconus who underwent KeraRing implantation from February 2008 to June 2009. Patients who had intraoperative or postoperative complications and/or did not complete at least 6 months of follow-up were excluded. All patients underwent complete ophthalmologic examinations that included measurement of the uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, and keratometry before and 2 days, 2 weeks, 1 month, and 3 and 6 months after surgery. The ring segments were chosen based on a nomogram from the manufacturer. RESULTS: Six months postoperatively, the mean UCVA increased significantly (P < 0.05) from 0.10 ± 0.11 to 0.32 ± 0.25 and the mean BSCVA increased from 0.36 ± 0.23 to 0.57 ± 0.24 (P < 0.05). The mean spherical refractive error significantly (P < 0.05) improved from -4.85 ± 2.90 diopters (D) to -1.89 ± 2.68 D, and the mean cylindrical refractive error significantly (P < 0.05) improved from -3.65 ± 1.70 D to -2.60 ± 1.62 D. The mean spherical equivalent significantly (P < 0.05) decreased from -6.68 ± 2.93 D to -3.19 ± 2.75 D, and the mean keratometry value decreased from 51.83 ± 4.14 D to 47.27 ± 3.68 D. The improvement in the UCVA and BSCVA continued over the 6-month postoperative period, but significant changes occurred only during the first 3 months. These changes occurred in patients with all grades of keratoconus. CONCLUSIONS: KeraRing implantation provided significant improvement in visual acuity, spherical equivalent, and keratometry results. This ICRS is an effective treatment for managing keratoconus and might delay or even avoid the need for penetrating keratoplasty.