This envelope may pull on the vitreous. A full-thickness retinal break, which may lead to total rhegmatogenous retinal detachment, may occur. Glaucoma secondary to rubeosis iridis may occur. Infection may cause a crisis. Preventing infections may avoid a sickle cell crisis.
Treatment is directed toward the underlying infection, hypoxia, dehydration, and pain.
Several systemic treatment strategies have evolved, including the inhibition of intracellular HbS polymerization and the polymer effects on the erythrocyte membrane, vasodilation, and modification of the interaction between the erythrocytes and blood vessels. This technique has been successful with the administration of 5-azacytidine, hydroxyurea, and, most recently, arginine butyrate. If the intraocular pressure remains elevated after a judicious trial of medical therapy, surgical intervention with an anterior chamber lavage is indicated. Modalities to treat PSR include diathermy, cryotherapy, xenon arc photocoagulation, and argon laser photocoagulation. Diathermy is used infrequently because of the high incidence of complications accompanying this procedure.