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Imaging Retinal Depression Sign in Sickle Cell Anemia Using Optical Coherence Tomography and the Retinal Thickness Analyzer

Akbar Shakoor, MD; Normal P. Blair, MD; Mahnaz Shahidi, PhD
Arch Ophthalmol. 2005;123(9):1278-1279. doi:10.1001/archopht.123.9.1278.
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Extract

The retinal depression sign was first described in sickle cell retinopathy in 1978 by Goldbaum.1 It represents an area of focal retinal infarction that may occur not only in the retinopathy of sickling hemoglobinopathies, but also in other microvascular disorders such as diabetic2 and hypertensive3 retinopathies.

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Figures

figure 1. Fundus photograph confirms the presence of the retinal depression sign superotemporal to the fovea (arrowheads). Note the dark area with a central light streak within the light reflecting from the internal limiting lamina. The areas demarcated by the square and circle outline the areas mapped using the retinal thickness analyzer and optical coherence tomography, respectively.

Grahic Jump Location

figure 2. A, Retinal thickness map generated by the retinal thickness analyzer shows diminished retinal thickness superotemporal to the fovea, corresponding spatially to the lesion observed on the fundus photograph (figure 1). B, Deviation probability map of the same eye using the retinal thickness analyzer, derived by comparison with the normative database, shows a well-delineated region of lower-than-normal thickness in the region occupied by the lesion. f indicates the fovea.

Grahic Jump Location

figure 3. A, A 6-mm optical coherence tomographic horizontal scan was obtained over the retinal area having the depression sign. The retinal depression was clearly visible (arrowhead). B, A 6-mm optical coherence tomographic scan through the center of the fovea displays the foveal depression. C, Retinal thickness map from optical coherence tomography of the same eye, generated from 6 radial scans through the fovea, displays the area of reduced retinal thickness with lesion boundaries not as well delineated as on the map obtained using the retinal thickness analyzer (Figure 2). f indicates the fovea.

Grahic Jump Location

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