Oral fluorescein angiography allows for more precise detection of sickle cell retinopathy in pediatric patients.

This study compares oral ultrawide-field fluorescein angiography (UWF-FA) to fundus photography in the detection of sickle cell retinopathy (SCR) and discusses the impact of genotype on SCR development. Thirty-two patients with sickle cell disease (SCD), 7-21 years of age, who underwent SCR screening with both imaging modalities were included. Four retina specialists masked to clinical information assessed SCR severity using the Goldberg classification system; their findings were compared to grades by an unmasked pediatric vitreoretinal specialist. In evaluating the UWF-FA images, the masked graders identified SCR in all 16 cases, as did the unmasked grader, but using fundus photographs they indicated the presence of SCR in only 75% of the same cases. SCR was more prevalent among HbSC (83%) and Hb-beta thalassemia trait (100%) patients compared with HbSS (38%).