Skip to main content
NCBI home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1985 Aug;69(8):629–632. doi: 10.1136/bjo.69.8.629

Conjunctival sign in sickle cell anaemia: an in-vivo correlate of the extent of red cell heterogeneity.

M S Roy, G P Rodgers, M J Podgor, C T Noguchi, A W Nienhuis, A N Schechter
PMCID: PMC1040692  PMID: 4016063

Abstract

A consecutive series of 22 stable adult inpatients with sickle cell anaemia were examined for the presence and severity of spontaneous 'comma' signs of the conjunctiva. Fifteen patients had severe conjunctival signs (more than 10 commas in the worse eye). The presence of severe conjunctival signs was associated with a broader distribution of intraerythrocytic haemoglobin concentrations (p = 0.0005). The patient group with severe conjunctival signs was not found to be significantly different from the group without such signs for age, sex, haemoglobin value, reticulocyte count, alpha-globin gene number, percentage fetal haemoglobin, or the proportion of very dense cells (CHC greater than 37 g/dl). Thus the singular heterogeneity of the erythrocytes in sickle cell disease may be indicative of the factor(s) responsible for the diagnostic comma sign.

Full text

PDF
629

Images in this article

630Image
on p.630

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. COMER P. B., FRED H. L. DIAGNOSIS OF SICKLE-CELL DISEASE BY OPHTHALMOSCOPIC INSPECTION OF CONJUNCTIVA. N Engl J Med. 1964 Sep 10;271:544–546. doi: 10.1056/NEJM196409102711105. [DOI] [PubMed] [Google Scholar]
  2. Clark M. R., Mohandas N., Shohet S. B. Deformability of oxygenated irreversibly sickled cells. J Clin Invest. 1980 Jan;65(1):189–196. doi: 10.1172/JCI109650. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. FINK A. I., FUNAHASHI T., ROBINSON M., WATSON R. J. Conjunctival blood flow in sickle-cell disease. Preliminary report. Arch Ophthalmol. 1961 Dec;66:824–829. doi: 10.1001/archopht.1961.00960010826008. [DOI] [PubMed] [Google Scholar]
  4. Higgs D. R., Pressley L., Serjeant G. R., Clegg J. B., Weatherall D. J. The genetics and molecular basis of alpha thalassaemia in association with Hb S in Jamaican Negroes. Br J Haematol. 1981 Jan;47(1):43–56. doi: 10.1111/j.1365-2141.1981.tb02760.x. [DOI] [PubMed] [Google Scholar]
  5. Noguchi C. T., Schechter A. N. The intracellular polymerization of sickle hemoglobin and its relevance to sickle cell disease. Blood. 1981 Dec;58(6):1057–1068. [PubMed] [Google Scholar]
  6. Noguchi C. T., Torchia D. A., Schechter A. N. Intracellular polymerization of sickle hemoglobin. Effects of cell heterogeneity. J Clin Invest. 1983 Sep;72(3):846–852. doi: 10.1172/JCI111055. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Oda S., Oda E., Tanaka K. R. Relationship of density distribution and pyruvate kinase electrophoretic pattern of erythrocytes in sickle cell diseases and other disorders. Acta Haematol. 1978;60(4):201–209. doi: 10.1159/000207716. [DOI] [PubMed] [Google Scholar]
  8. PATON D. The conjunctival sign of sickle-cell disease. Arch Ophthalmol. 1961 Jul;66:90–94. doi: 10.1001/archopht.1961.00960010092020. [DOI] [PubMed] [Google Scholar]
  9. PATON D. The conjunctival sign ox sickle-cell disease. Further observations. Arch Ophthalmol. 1962 Nov;68:627–632. doi: 10.1001/archopht.1962.00960030631010. [DOI] [PubMed] [Google Scholar]
  10. Schechter A. N., Bunn H. F. What determines severity in sickle-cell disease? N Engl J Med. 1982 Feb 4;306(5):295–297. doi: 10.1056/NEJM198202043060510. [DOI] [PubMed] [Google Scholar]
  11. Serjeant G. R., Serjeant B. E., Condon P. I. The conjunctival sign in sickle cell anemia. A relationship with irreversibly sickled cells. JAMA. 1972 Mar 13;219(11):1428–1431. [PubMed] [Google Scholar]
  12. Wilson J. T., Wilson L. B., deRiel J. K., Villa-komaroff L., Efstratiadis A., Forget B. G., Weissman S. M. Insertion of synthetic copies of human globin genes into bacterial plasmids. Nucleic Acids Res. 1978 Feb;5(2):563–581. doi: 10.1093/nar/5.2.563. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES