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Visual cortex changes in children with sickle cell disease and normal visual acuity: a multimodal magnetic resonance imaging study
Author(s) -
Manara Renzo,
Dalla Torre Alice,
Lucchetta Marta,
Ermani Mario,
Favaro Angela,
Baracchini Claudio,
Favaretto Silvia,
Viaro Federica,
Munaretto Vania,
Sartori Stefano,
Ponticorvo Sara,
Russo Andrea G.,
Biffi Alessandra,
Sainati Laura,
Colombatti Raffaella
Publication year - 2021
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.17042
Subject(s) - medicine , magnetic resonance imaging , visual acuity , transcranial doppler , visual cortex , functional magnetic resonance imaging , ophthalmology , retina , radiology , neuroscience , psychology
Summary The visual system is primarily affected in sickle cell disease (SCD), and eye examination is recommended starting in late childhood. So far, to our knowledge, all studies have focused on the retina, neglecting the changes that might be present in the cortical portion of the visual system. We performed a multimodal magnetic resonance imaging (MRI) evaluation of the visual cortex in 25 children with SCD (mean age: 12·3 ± 1·9 years) and 31 controls (mean age: 12·7 ± 1·6 years). At ophthalmologic examination, 3/25 SCD children had mild visual acuity deficits and 2/25 had mild tortuosity of the retinal vessels. None showed optic pathway infarcts at MRI or Transcranial Doppler abnormal blood velocities, and 6/25 disclosed posterior cerebral artery stenosis (five mild and one severe) at MR‐angiography. Compared to controls, SCD children had increased posterior pericalcarine cortical thickness, with a different trajectory of cortical maturation and decreased connectivity within medial and ventral visual neural networks. Our findings suggest that SCD affects the development and the tuning of the visual cortex, leading to anatomical and functional changes in childhood even in the absence of retinopathy, and set the basis for future studies to determine if these changes can represent useful predictors of visual impairment in adulthood, biomarkers of disease progression or treatment response.