Laboratory Studies

Laboratory studies may be performed per internal medicine/hematology consultation, as follows:

Hemoglobin electrophoresis
Oxygen saturation
Systemic hydration/acidosis

Imaging Studies

Imaging studies may be performed per internal medicine/hematology consultation.

Other Tests

Perform fluorescein angiography when the examination does not explain the degree of vision loss.

Perform ocular B-scan ultrasonography when unable to adequately visualize the retina.

Consider cerebral vascular accident (CVA).

Consider retinal vascular emboli.

Histologic Findings

Histologic findings may include the following:

Retinal pigment epithelium (RPE) atrophy
RPE hyperplasia
RPE migration into partially degenerated retina and perivascular location
Retinal thinning with loss of outer retinal layers
Retinal detachment with cystic degeneration
Retinal layers may be disorganized.
Pigment-laden macrophages are seen within and beneath the retina.
Pupillary space may be filled by a thin fibrovascular membrane.
Cataractous changes may be noted.
Thick-walled blood vessels often are filled with sickled erythrocytes.
Proliferation of blood vessels may be seen in the retina and the vitreous, leading to intravitreal neovascularization.^[23]

Treatment & Management

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Media Gallery

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Author

Brian A Phillpotts, MD Ophthalmologist, St Luke's Cataract and Laser Institute

Brian A Phillpotts, MD is a member of the following medical societies: American Academy of Ophthalmology, American Diabetes Association, American Society of Retina Specialists, Association for Research in Vision and Ophthalmology, Association of University Professors of Ophthalmology

Disclosure: Nothing to disclose.

Coauthor(s)

Hon-Vu Quang Duong, MD Clinical Instructor of Ophthalmology and Ophthalmic Pathology, Westfield Eye Center; Senior Lecturer of Neurosciences (Anatomy and Physiology), Nevada State College

Hon-Vu Quang Duong, MD is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Steve Charles, MD Founder and CEO of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine

Disclosure: Received royalty and consulting fees for: Alcon Laboratories.

Chief Editor

Hampton Roy, Sr, MD † Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Russell P Jayne, MD Vitreoretinal Surgeon, The Retina Center at Las Vegas

Russell P Jayne, MD is a member of the following medical societies: American Medical Association, American Society of Cataract and Refractive Surgery, American Society of Retina Specialists

Disclosure: Nothing to disclose.

Michael J Shapiro, MD Associate Professor, Vitreoretinal Service, Director, Eye Trauma Services, Department of Ophthalmology, University of Illinois at Chicago; Vitreoretinal Consultant, Pediatric Genetics and Birth Defects Clinic

Michael J Shapiro, MD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Society of Retina Specialists

Disclosure: Nothing to disclose.

Oswaldo Castro, MD Senior Advisor, Center for Sickle Cell Disease, Professor Emeritus of Medicine and Pediatrics, College of Medicine

Disclosure: Nothing to disclose.

Richard G Fiscella, PharmD, MPH Clinical Professor, Departments of Pharmacy and Ophthalmology, University of Illinois at Chicago

Disclosure: Nothing to disclose.