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Dr.Farzeen Safdar, Dr.Irum Tariq, Dr.Muhammad Kaleem Abbas Gurmani
Background- Due to pre-mature RBC destruction and unpredictable vasocclusion episodes sickle cell disease happens which give rise to tissue ischemia and acute pain. Dysfunction of endothelial occurs in kidneys due to nephron leading to infarction, ischemia, vaso-occlusion, microalbuminuria which ultimately causes the loss of nephron. Due to this retinal change non-proliferative and proliferative occurs. Objective- To find the relation between the Ophthalmic complications and Nephropathy in cases of sickle cell anemia. Methods- For this study 35 adults were selected from outpatient department of Bahawalpur Victoria Hospital , whose age were between 18 to 60 years and they all were suffering in disease of sickle cell. Blood samples were collected, and complete blood analysis were done as well as assessment of urine albumin: ophthalmic findings and creatinine ratio, studied by slit-lamp biomicroscopy indirect and direct ophthalmoscopy. Result- Two groups were made on the bases of two categories in which first one consist of seven patients who were admitted to Victoria Hospital Bahawalpur and the other category consist of twenty eight patients who were clinically stable. Peripheral retinopathy was found in 7.1% patients i.e. 2 of category 2 and 71.4% patients of first category. The patients of category 1 and category 2 had mean of 6.17 ± 2.14 and 2.89 ± 1.81blood transfusions respectively. Mean Hb in patients of category 2 was 7.95 ± 0.81 gm whereas in patients of category 1 it was 6.37 ± 0.35 gm/dl. The patients of Ophthalmic manifestations had the mean creatinine ratio/ urine albumin 286.71 ± 74.75 mg/g while it was 31.82 ± 4.48 mg/g in patients who had no Ophthalmic manifestations, this difference was very significant. Conclusion- It was concluded in this study that the manifestation of sickle vasculopathy mechanism is correlated with sickle cell retinopathy and nephropathy and these are regarded as the indicators of each other. Keywords: Urine albumin/creatinine ratio, sickle retinopathy, sickle nephropathy, sickle cell disease