Scatter photocoagulation is efficacious in the treatment for sea fan lesions. The desired outcome of this therapy is extraretinal fibroneovascular tissue regression. Localized scatter photocoagulation treats early proliferative changes. Once neovascularization invades the vitreous, localized scatter photocoagulation is generally less effective. If this technique does not result in regression of proliferative changes, feeder vessel photocoagulation may be used as an adjunct to induce infarction to the remaining sea fans. Feeder vessel photocoagulation

Obliterating feeder vessels by retinal photocoagulation causes infarction of peripheral neovascular beds. This technique manages proliferative sickle retinopathy effectively, especially in cases where neovascularization persists after extensive scatter photocoagulation treatment 6. Feeder vessel photocoagulation is often complicated by vitreous hemorrhage, retinal detachments, choroidal ischemia, choroidal neovascularization, subretinal hemorrhage and/or fibrosis, or macular pucker and hole formation.

Retinal cryotherapy

Retinal cryotherapy is useful in treating peripheral retinal ischemia as opposed to directly obliterating these neovascular beds. This methodology of "indirect" obliteration of the neovascular bed results in regression of abnormal vessels with minimal complications. Cryotherapy often is limited to cases with cloudy ocular media.

Vitrectomy

Vitrectomy is indicated in cases of nonresolving vitreous hemorrhage and retinal detachment (stages IV and V). This procedure relieves the internal tractional forces that act on the retina and facilitate retinal photocoagulation. Complications...

Although some authors have questioned whether retinopathy is actually a sickle cell trait 9. Surgical treatment is indicated once retinopathy advances to the proliferative stage. Several treatment options may be utilized, but should be chosen to meet the patient's medical history and disease severity.
References

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2. Aiello LP. Clinical implications of vascular growth factors in proliferative retinopathies. Curr Opin Ophthalmol 1997;8:19-31.

3. Goldberg MF. Classification and pathogenesis of proliferative sickle retinopathy. Am J. Ophthalmol 1971;71:649-65.

4. Charache S. Eye disease in sickling disorders. Hematol Oncol Clin North Am 1996;10:1357-62.

5. Morel C. [Retinal involvement in hemoglobinopathy]. J Fr Ophtalmol 2001;24:987-92.

6. Spires R. Ocular manifestations of sickle cell disease. J Ophthalmic Nurs Technol 1995;14:74-7.

7. Fany a, Boni S, Adjorlolo C, et al. [Retinopathy as a sickle-cell trait: myth or reality?]. J Fr Ophtalmol 2004;27:1025-30.

8. Nia J, Lam WC, Kleinman DM, Kirby M, Liu ES, Eng KT. Retinopathy in sickle cell trait: does it exist? Can J. Ophthalmol 2003;38:46-51.

9. Kehinde MO, Akinsola FB. Ocular findings in sickle cell disease patients in lagos. Niger Postgrad Med J. 2004;11:203-6.