Profound Presentation of Retinopathy in a Patient with Sickle Cell Trait and Diabetes Mellitus

A 43-year-old functionally monocular African American woman with longstanding type 2 diabetes mellitus presented for care of her better-seeing left eye. Originally suspected of having proliferative diabetic retinopathy (PDR) as the cause of her bilateral visual impairment, fluorescein angiography and optical coherence tomography angiography revealed a marked peripheral nonperfusion which was out of proportion for a typical diabetic retinopathy (Figure 1). A comprehensive uveitic and vasculopathic workup was therefore initiated. The workup was largely negative except for hemoglobin electrophoresis, which was consistent with the sickle cell trait (or hemoglobinopathy) (Table 1). The patient was counseled on her diagnosis and continues to be treated with laser photocoagulation for her peripheral neovascularization.