Cross-Sectional analysis of neurocognitive function, retinopathy, and retinal thinning by Spectral-Domain optical coherence tomography in sickle cell patients
Erica Z Oltra1, Clement C Chow2, Thomas Wubben3, Jennifer I Lim3, Felix Y Chau3, Heather E Moss3
1 Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL; Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA
2 Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL; Retinal Diagnostic Center, Campbell, CA, USA
3 Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
Heather E Moss
Department of Ophthalmology and Visual Sciences, University of Illinois, 1855 W. Taylor Street, M/C 648, Chicago, IL 60612
Source of Support: Illinois Society for the Prevention of Blindness, Research
to Prevent, Blindness, NIH K12 EY02147, Conflict of Interest: None
Purpose: The purpose was to examine the relationship between neurocognitive function and two distinct forms of retinopathy in sickle cell disease.
Materials and Methods: Patients with sickle cell disease (n = 44, age range: 19-56 years, 70% female) were prospectively recruited for this cross-sectional study. Retinopathy was characterized by: (1) Presence of focal retinal thinning on spectral domain optical coherence tomography and (2) determination of the sickle retinopathy stage on funduscopic exam based on Goldberg classification. Neurocognitive function was assessed using the Philadelphia Brief Assessment of Cognition (PBAC), a validated test of cognition. Univariate and multivariate analyses for PBAC score outcomes were performed. Retinal thinning and retinopathy stage were primary variables of interest and age, gender, genotype, education, and history of stroke were covariates.
Results: Univariate analysis revealed associations with total PBAC score and age (P = 0.049), history of stroke (P = 0.04), and genotype (P < 0.001). Focal retinal thinning and Goldberg retinopathy stage were not associated with each other in this sample. Neither the presence of focal retinal thinning nor degree of retinopathy was associated with total PBAC score in univariate or multivariate analyses.
Conclusions: We find an association between lower cognitive function and older age, history of stroke and sickle cell genotype SS in patients with sickle cell disease. Our data do not provide evidence to support an association between cognitive function and retinopathy in sickle cell patients.