Certified Ophthalmic Medical Technologist (COMT) Practice Exam

Sickle cell retinopathy often begins in which part of the retina?

1. Fovea

2. Peripheral retina

3. Central retina

4. Macula

The correct answer is: Peripheral retina

Sickle cell retinopathy typically begins in the peripheral retina. This is primarily due to the nature of sickle cell disease, which causes vaso-occlusive episodes that affect the smaller blood vessels. The peripheral retina is more susceptible to ischemia as it has a less robust blood supply compared to other areas, such as the central retina and macula. As sickle-shaped red blood cells obstruct the microcirculation in the retina, it leads to areas of retinal ischemia and damage, which are most commonly observed in the peripheral regions first. The fovea, central retina, and macula contain a higher density of vasculature and are thus better perfused, making them less likely to experience the initial changes associated with sickle cell retinopathy. Consequently, the onset of this condition is characterized by changes in the peripheral retina where the compromised blood supply is first evident.