In sickle cell retinopathy, the Goldberg classification Stage III represents which pathological change?
- A Sea-fan neovascularisation (proliferative sickle retinopathy) ✓
- B Arteriovenous anastomoses at the border of perfused and non-perfused retina
- C Vitreous haemorrhage
- D Traction or rhegmatogenous retinal detachment
Explanation
The Goldberg classification of sickle cell retinopathy stages proliferative changes: Stage I = peripheral arteriolar occlusions; Stage II = peripheral arteriovenous anastomoses at the ischaemia border; Stage III = sea-fan neovascularisation (named for its shape resembling the marine organism Gorgonia flabellum) arising from the AVA; Stage IV = vitreous haemorrhage; Stage V = traction/rhegmatogenous retinal detachment. Sea-fans (Stage III) may undergo spontaneous autoinfarcaion (a self-limiting feature unique to sickle retinopathy) due to sickled cells occluding the feeding vessel. Laser photocoagulation of sea-fan neovascularisation is indicated when it does not auto-infarct.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
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