Sickle Cell Retinopathy- Fresh Retinal Hemorrhage Evolving into a Sunburst Lesion

These two images are taken from a 16-year-old African-American male with sickle cell retinopathy. The red arrow on the fluorescein angiogram highlights an area of preretinal hemorrhage associated with retinal neovascularization. It blocks the underlying hyperfluorescent retinal vessel. This area later evolved into a sunburst lesion 8 months later on the wide-angle optos (pigmented ellipse indicated by the blue arrow). There is also an area of scarring indicated by the green arrow in the fluorescein angiogram frame; this is the appearance of a sunburst lesion as captured by fluorescein angiography. The yellow arrows indicate additional areas of sunburst lesions. The blood elicits a metaplastic change in the retinal pigment epithelium producing the pigmented scar. This patient’s visual acuity is20/25 with the left eye.