Choroidal neovascularisation induced by photocoagulation in sickle cell disease

Abstract

Choroidal neovascularisation occurred in 35 out of 57 (61%) patients during a trial of xenon arc photocoagulation in proliferative sickle retinopathy. Nineteen patients manifested abnormal vessel systems in the plane of the retina which tended to be benign, not enlarging, and without complications (choroidoretinal neovascularisation). In 16 patients the abnormal vessel systems grew into the vitreous, tended to increase in size, and to be associated with vitreous haemorrhage and retinal traction (choroidovitreal neovascularisation). Both forms of neovascularisation were significantly more common at younger ages. Treatment was generally unsatisfactory, frequently resulting in further enlargement of the lesions. Although the natural history of choroidal neovascularisation and its ultimate effect on visual function remains to be recorded, these lesions constitute a common and potentially serious complication of xenon arc photocoagulation in proliferative sickle retinopathy as currently performed.