Computer-assisted evaluation of retinal vessel tortuosity in children with sickle cell disease without retinopathy

Objective: We assessed the predictive efficacy of automatically quantified retinal vascular tortuosity from the fundus pictures of patients with sickle cell disease (SCD) without evident retinopathy. Methods: Retinal images were obtained from 31 healthy and 31 SCD participants using fundus imaging and analyzed using a novel computational automated metric assessment. The local and global vessel tortuosity and their relationship with systemic disease parameters were analyzed based on the images. Results: SCD arteries had an increased local tortuosity index compared to the controls (0.0007 +/- 0.0019 vs. 0.0006 +/- 0.0014, p = 0.019). Furthermore, the SCD patients had wider vessel caliber mainly in the arteries (14.68 +/- 5.3 vs. 14.06 +/- 5.3, p < 0.001). The SCD global tortuosity did not differ significantly from that of the controls (p = 0.598). The female participants had significantly reduced retinal vessel tortuosity indices compared to the male participants (p = 0.018). Conclusion: Retinal arterial tortuosity and caliber were reliable and objective measures that could be used as a non-invasive prognostic and diagnostic indicator in sickle cell retinopathy. Further studies are required to correlate these local vascular parameters to systemic risk factors and monitor their progression and change over time.