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 and Umar K. Mian ()
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Patricia Zulueta: Albert Einstein College of Medicine, New York, NY 10461, USA
Caterina P. Minniti: Albert Einstein College of Medicine, New York, NY 10461, USA
Anvit Rai: Albert Einstein College of Medicine, New York, NY 10461, USA
Tiana J. Toribio: Department of Ophthalmology & Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA
Jee-Young Moon: Department of Epidemiology & Population Health, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA
Umar K. Mian: Department of Ophthalmology & Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA

IJERPH, 2023, vol. 20, issue 4, 1-8

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: sickle cell disease; sickle cell retinopathy; screening (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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