This patient has a classic case of retinopathy secondary to Sickle Cell Disease. The angioid streaks around the disk are not unusual in Sickle Cell patients, but the starburst scar inferiorly is a give-away sign, revealing the location of a previous "Salmon Patch" hemorrhage.

These patients are rarely symptomatic unless more severe events occur, such as neovascularization secondary to the angioid streaks, hemorrhages, or peripheral neovascular "sea-fans". Occasional vitreous hemorrhage can occur, which can lead to traction and possible retinal detachment.

Treatment of hemorrhage or detachment should be given if they occur. Watching for signs of neovascularization secondary to the angioid streaks in this patient was indicated. Typical management of cases without angioid streaks or other retinopathy is simple year-to-year monitoring. Those with retinal pathology must be followed carefully, with the involvement of a retinal specialist strongly worth considering.