Routine Ophthalmological Examination Rates in Adults with Sickle Cell Disease Are Low and Must Be Improved

Patricia Zulueta; Caterina P Minniti; Anvit Rai; Tiana J Toribio; Jee-Young Moon; Umar K Mian

doi:10.3390/ijerph20043451

Routine Ophthalmological Examination Rates in Adults with Sickle Cell Disease Are Low and Must Be Improved

Int J Environ Res Public Health. 2023 Feb 16;20(4):3451. doi: 10.3390/ijerph20043451.

Authors

Patricia Zulueta¹, Caterina P Minniti¹, Anvit Rai¹, Tiana J Toribio^{2

3}, Jee-Young Moon⁴, Umar K Mian^{2

3}

Affiliations

¹ Albert Einstein College of Medicine, New York, NY 10461, USA.
² Department of Ophthalmology & Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA.
³ Department of Pediatrics, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA.
⁴ Department of Epidemiology & Population Health, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA.

Abstract

The American Academy of Ophthalmology and the National Heart, Lung and Blood Institute recommend patients with sickle cell disease (SCD) undergo dilated funduscopic exams (DFE) every 1-2 years to screen for sickle retinopathy. There is a paucity of data on the adherence rate to these guidelines; a retrospective study was performed to evaluate our institution's adherence. A chart review of 842 adults with SCD, seen 3/2017-3/2021 in the Montefiore healthcare system (All Patients), was done. Only about half of All Patients (n = 842) had >1 DFE during the study period (Total Examined Patients, n = 415). The Total Examined Patients were categorized as screening, those without retinopathy (Retinopathy-, n = 199), or follow-up, including individuals previously diagnosed with retinopathy (Retinopathy+, n = 216). Only 40.3% of screening patients (n = 87) had DFE at least biennially. As expected, there was a significant decrease in the average DFE rate of the Total Examined Patients after the COVID-19 pandemic started (13.6%) compared to pre-COVID (29.8%, p < 0.001). Similarly, there was a significant decrease in the screening rate of Retinopathy- patients from 18.6% on average pre-COVID to 6.7% during COVID (p < 0.001). This data shows the sickle retinopathy screening rate is low and innovative approaches may need to be employed to remedy this issue.

Keywords: screening; sickle cell disease; sickle cell retinopathy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anemia, Sickle Cell*
COVID-19*
Humans
Pandemics
Retinal Diseases* / diagnosis
Retinal Diseases* / epidemiology
Retrospective Studies

Grants and funding

The work of the first author herein was supported by a $2500 research fellowship stipend for medical students from the Office of Medical Student Research at the Albert Einstein College of Medicine.