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      Retinopatia falciforme em crianças Translated title: Sickle cell retinopathy in children

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          Abstract

          RESUMO Exames oftalmológicos foram realizados em 50 crianças (faixa etária: 9 meses e 14 anos) portadoras de hemoglobinopatias. Tortuosidade vascular aumentada foi verificada em 24% das crianças. Lesões do tipo "black sunburst" foram vistas em 12% dos casos. Hemorragias em placa de salmão (salmon-patch) ocorreram em 4%, obliteração arteriolar e retinopatia proliferativa mostraram-se presentes em apenas 1 caso, subseqüentemente submetido a fotocoagulação preventiva. A prevalência das lesões retinianas mostrou-se maior com o aumento da faixa etária. Este trabalho enfatiza a importância do exame oftalmológico de pacientes com anemia falciforme e suas variantes a partir da idade de 10 anos para possibilitar a detecção precoce e o tratamento imediato da forma proliferativa que pode levar à cegueira.

          Translated abstract

          SUMMARY Ophthalmic examinations were performed on 50 children (aged 9 months-14 years) with hemoglobinapathies. Venous tortuosity was pre sent in 24% of the children, black sunburst lesions were seen in 12% of the cases. Salmon-patch hemorrhages ocured in 4%, arteriolar obliteration and proliferative retinopathy were seen in only one case and this palient subsequently underwent a preventive laser treatment. The prevalence of the retina lesions was as sociated to the increasing of the age of the patient. This work emphasizes the importance of the ophthalmic examination beginning at the age of 10 years old towards to the early detection and imediate treatment of the proliferative phase which some times may cause blindness.

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          Classification and pathogenesis of proliferative sickle retinopathy.

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            The conjunctival sign of sickle-cell disease.

            Carl Paton (1961)
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              Sickle cell retinopathy in young children in Jamaica.

              Ophthalmological examinations were performed on 59 of the 74 (80%) children with homozygous sickle cell (SS) disease and on 37 of the 54 (69%) children with sickle cell-haemoglobin C (SC) disease, aged 5-7.5 years, within the cohort study of sickle cell disease. Arteriolar sheathing was the commonest retinal vessel abnormality, occurring in 30/59 (51%) SS children and in 11/37 (30%) SC children. Peripheral arteriolar closure was observed in 14 (24%) SS children and in 6 (16%) SC children. Arteriovenous anastomoses were seen in 3 children, but proliferative retinopathy was not identified. Capillary changes often occurred in patients without confluent closure, suggesting that complex remodelling of the capillary bed may precede retinal non-perfusion. Discrete retinal patches similar to schisis cavities resulting intraretinal haemorrhages were found in 22 (37%) SS children and in 9 (24%) SC children, but haemorrhages were observed in only 2 patients (1 SS, 1 SC). Vitreous opacities were common and were generally associated with retinal vessel disease. Retinal changes were consistently more common in children with SS disease, though the differences failed to reach statistical significance. The prevalence of peripheral vascular closure and retinal patches showed a significant upward trend with age. These observations contrast with the greater prevalence of proliferative retinopathy characterising SC disease in adults.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                abo
                Arquivos Brasileiros de Oftalmologia
                Arq. Bras. Oftalmol.
                Conselho Brasileiro de Oftalmologia (São Paulo, SP, Brazil )
                0004-2749
                1678-2925
                August 1990
                : 53
                : 4
                : 158-162
                Affiliations
                [1] São Paulo orgnameFaculdade de Medicina de Jundiaí orgdiv1Setor de Retina Brazil
                [3] São Paulo orgnameUniversidade Federal de São Paulo orgdiv1Setor de Retina Brazil
                [2] São Paulo orgnameUniversidade Federal de São Paulo orgdiv1Departamento de Pediatria Brazil
                [4] orgnameHospital Santa Cruz Brazil
                [5] São Paulo orgnameUniversidade Federal de São Paulo Brazil
                Article
                S0004-27491990000400158
                10.5935/0004-2749.19900019
                0f0cebdc-32ef-4ff9-b73c-0b7dc5322466

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 10, Pages: 5
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                SciELO Brazil


                retinopatia proliferativa,"sea fan",hemoglobinopatias,anemia falcilorme

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