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Retinopathy in sickle cell patients is most commonly associated with hemoglobin type SC. This condition arises due to the presence of both sickle hemoglobin (HbS) and hemoglobin C (HbC), which can lead to more complex vascular changes in the retina. The combination of these hemoglobinopathies causes occlusive episodes, contributing to the prevalence of retinal damage and proliferative retinopathy.

In contrast, hemoglobin type SS is associated with sickle cell disease and can also lead to retinopathy, but the incidence and severity may not reach the levels seen in patients with hemoglobin SC. Hemoglobin AA represents normal adult hemoglobin and does not lead to any of the complications associated with sickle cell disease or retinopathy. Hemoglobin AS indicates a carrier state of sickle cell trait, which generally does not cause significant health issues or complications like retinopathy. Therefore, hemoglobin SC is most directly linked to the increased risk of retinopathy in sickle cell patients due to the unique pathophysiological changes it induces in the retinal vasculature.