Branch Retinal Vein Occlusion as a Clinical Manifestation of Sickle Cell Trait: A Case Report.

Authors

  • Dr. Josephine Bindu Prathipaty Senior Resident, Department of Pathology, NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India Author
  • Dr. Jyothsna Duvvada Final Year Postgraduate, Department of Ophthalmology, NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India Author
  • Dr. Dharma Raju Bennabhaktula Professor, Department of Ophthalmology, NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India Author
  • Dr. Bhagyalakshmi Atla Professor and Head of the Department, Department of Pathology, NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India Author

DOI:

https://doi.org/10.51168/khs6vf72

Keywords:

Branch Retinal Vein Occlusion, Clinical Manifestation, Sickle Cell

Abstract

Background

Sickle hemoglobin disorders are associated with vaso-occlusive and hyperviscosity-related complications involving multiple organ systems, including the eye. Ocular manifestations usually include non-proliferative or proliferative sickle retinopathy, whereas retinal vein occlusion is less commonly emphasized, particularly in individuals with sickle cell trait. This case highlights branch retinal vein occlusion as a clinically significant ophthalmic manifestation associated with sickle cell trait.

 Case presentation

A 41-year-old man from Araku Valley presented with sudden blurring of vision in the right eye for 10 days, associated with decreased vision and recurrent headache. Ocular examination showed a positive comma sign in the inferior bulbar conjunctiva of both eyes. Fundus examination of the right eye revealed diffuse superficial hemorrhages with sclerotic arterioles in the superotemporal quadrant and associated macular edema, leading to a diagnosis of superotemporal branch retinal vein occlusion. Hematological evaluation showed mild anemia with microcytic indices, fragmented red blood cells, and a positive sickling test after 24 hours. High-performance liquid chromatography showed a heterozygous sickle hemoglobin pattern, with HbS at 23.8%, consistent with sickle cell trait. Extensive systemic evaluation for alternative causes of retinal vein occlusion, including thrombophilia, autoimmune, and vasculitic profiles, was negative. The patient was treated with three intravitreal ranibizumab injections and laser photocoagulation for ischemic retina, following which macular edema resolved and visual acuity stabilized at 6/9.

 Conclusions

Branch retinal vein occlusion can occur as an important ocular manifestation of sickle cell trait after exclusion of other etiologies. Early ophthalmic recognition, hematological confirmation, and timely intervention are crucial for visual recovery and prevention of recurrent retinal vascular events in susceptible individuals.

Author Biographies

  • Dr. Josephine Bindu Prathipaty, Senior Resident, Department of Pathology, NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India

    MBBS, MD Pathology, is a Senior Resident in the Department of Pathology at NRI Institute of Medical Sciences, Visakhapatnam. She completed her undergraduate training at Guntur Medical College and earned her MD in Pathology from GITAM Institute of Medical Sciences and Research. Her academic interests include diagnostic pathology, case-based research, and evidence synthesis. She has presented papers and posters at national academic meetings.

  • Dr. Jyothsna Duvvada, Final Year Postgraduate, Department of Ophthalmology, NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India

    MBBS, is a final-year postgraduate trainee in Ophthalmology at NRI Institute of Medical Sciences, Visakhapatnam. She graduated from Katuri Medical College and Hospitals, Guntur, and is pursuing her MS in Ophthalmology. Her academic work focuses on ocular trauma and retinal disorders. She has presented papers and posters at Eyecon meetings and national conferences, reflecting her active involvement in clinical ophthalmic research.

  • Dr. Dharma Raju Bennabhaktula, Professor, Department of Ophthalmology, NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India

    MBBS, MS Ophthalmology, is a Professor of Ophthalmology at NRI Institute of Medical Sciences, Visakhapatnam, with 27 years of academic and teaching experience. He has served in several leading medical colleges in Andhra Pradesh and has contributed to undergraduate and postgraduate medical education as an examiner and assessor. His professional profile includes scientific publications, national training programs, and sustained involvement in ophthalmic teaching and research.

  • Dr. Bhagyalakshmi Atla, Professor and Head of the Department, Department of Pathology, NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India

    MBBS, MD Pathology, is Professor and Head of the Department of Pathology at NRI Institute of Medical Sciences, Visakhapatnam. She holds an MBBS (1982) and an MD in Pathology (1992) from Andhra Medical College, Visakhapatnam, and has over 37 years of teaching and professional experience. She previously served as Professor and Head, and Vice Principal (Admin), Andhra Medical College, Visakhapatnam, and retired from government service in 2021 after distinguished contributions to medical education and research.

    She has held numerous leadership positions, including Vice Chairman of the Scientific and Research Committee and Coordinator of the PG Medical Education Committee at NRIIMS, Executive Council Member of Dr. NTR University of Health Sciences (2021–2024), Chairperson of the AMC Research Forum, and PhD guide in pathology under Dr. NTRUHS. She has also served as Chairperson of undergraduate and postgraduate examination boards, MCI assessor for UG/PG courses, and nodal officer of the Multidisciplinary Research Unit (MRU), AMC, where she was principal investigator for four funded projects.

References

1. Rao P, Raj EA, Natesan S, Gudi N. Prevalence of Sickle cell disease, Sickle cell trait and HBS-beta-thalassemia in India: A systematic review and Meta-analysis. Clinical Epidemiology and Global Health [Internet]. 2024 Jul 1;28:101678. Available from: https://www.sciencedirect.com/science/article/pii/S221339842400174X https://doi.org/10.1016/j.cegh.2024.101678

2. Means RT, editor. Wintrobe’s clinical hematology. Fifteenth edition. Philadelphia: Wolters Kluwer; 2024. 2980–3059 p.

3. Cotran RS, Robbins SL. Robbins & Cotran's Pathologic Basis of Disease. Tenth edition. Kumar V, Abbas AK, Aster JC, editors. Philadelphia, Pa.: Elsevier; 2021. 641–644 p.

4. Sambhara D. EyeWiki. 2025. Sickle Cell Retinopathy. Available from: https://eyewiki.org/Sickle_Cell_Retinopathy

5. Abdelaziz M, Tripathy K, Hsu J, Bhagat N, Lim JI, Marcet MM. EyeWiki. Branch retinal vein occlusion. Available from: https://eyewiki.org/Branch_Retinal_Vein_Occlusion

6. American academy of ophthalmology. Basic and clinical science course complete print set 2023, 2024. Nielsen bookdata, 2023. Retina and vitreous 12. 167-174 p.

Downloads

Published

2026-03-30

Issue

Vol. 3 No. 1 (2026): March 2026 Issue

Section

Original Articles

License

Copyright (c) 2026 Dr. Josephine Bindu Prathipaty, Dr. Jyothsna Duvvada, Dr. Dharma Raju Bennabhaktula, Dr. Bhagyalakshmi Atla (Author)

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

Branch Retinal Vein Occlusion as a Clinical Manifestation of Sickle Cell Trait: A Case Report. (2026). SJ General Medicine Africa, 3(1), 6. https://doi.org/10.51168/khs6vf72

Similar Articles

You may also start an advanced similarity search for this article.