[00:00] Maria Berrocal: Hello and welcome to this episode of Clinical Minute. I am your host, Maria Berrocal. Today I'm joined by my sister, Dr. Nina Berrocal, who wrote a paper with her colleagues at Bascom Palmer examining the intersection of socioeconomic demographics and outcomes of proliferative sickle retinopathy. [00:00:30] Maria Berrocal: Dr. Berrocal, thank you so much for joining me. [00:00:37] Nina Berrocal: Thank you, Maria. It's great being with you doing this. So thank you for having me. [00:00:46] Maria Berrocal: So this paper was very interesting because it is a very large review of patients with proliferative sickle retinopathy, analyzing their situation, where they live, et cetera. What were the main findings that you saw? [00:01:00] Nina Berrocal: Well, it's interesting. We were surprised to see that there is no correlation between socioeconomic status and sickle cell, which was surprising when you think that it's a disease mainly in the Black population. But when you think of Bascom Palmer, University of Miami, we have a great hematology-oncology department that takes care of this vulnerable population. And the physicians that have been there have been, like me, 20-something years, 30 years taking care of them. There is great communication between that department and Bascom Palmer, so they are really good at sending these patients to us. I don't think those findings are seen in other parts of the United States. I think that if we were to do this elsewhere, I would be surprised if those were the same findings. But it speaks to the importance of having hematologist-oncologists be really aware of what the needs are of those patients, especially because, as you know, SC disease is not really affecting the system. It's more of an eye disease. At Bascom Palmer and UM, they send all the SC patients to us early on so we can really follow them. So I don't think you can translate that to the entire nation. [00:02:23] Maria Berrocal: Okay. And thinking about this, probably these patients get diagnosed by the hematologist because of family screening, community support, and sickle cell awareness campaigns. How do they get initially diagnosed? [00:02:40] Nina Berrocal: Well, interesting you say that because after having worked in the NICU for so many years, infant screening at birth—every baby born in the state of Florida gets newborn screening. As part of that screening, we test for sickle cell trait. There is a conscious effort to inform parents that their child has the trait and needs follow-up. So we trace them from the very beginning. [00:03:13] Maria Berrocal: So that is really wonderful. I don't know if that is the case in all states. [00:03:18] Nina Berrocal: Yeah, I'm not sure if that's the case. [00:03:21] Maria Berrocal: But I think having sickle cell centers in areas where you have a much higher incidence, just like the University of Miami does with Bascom Palmer, would really change the outcome of many of these eyes. [00:03:36] Nina Berrocal: I remember when I did my residency in Boston, I saw maybe one sickle cell patient. But when I came to Miami, we see a lot. Even that is different. Residents training in areas without a large Black population may never be exposed to sickle cell disease. This year, my fellow from the Dominican Republic told me he sees tons of sickle cell. [00:04:03] Maria Berrocal: That's very interesting because I don't see much sickle cell in Puerto Rico at all. [00:04:09] Nina Berrocal: Yeah, because I think our populations are ethnically different. [00:04:14] Maria Berrocal: Ethnically different. [00:04:16] Nina Berrocal: Yes. [00:04:18] Maria Berrocal: Yeah. Yeah. That is fascinating. [00:04:20] Nina Berrocal: Yes. [00:04:22] Maria Berrocal: Well, thank you very much, Dr. Berrocal, for researching this important topic and sharing your findings with us. We'll be back soon with another key paper and another expert voice. [00:04:40] Maria Berrocal: Until then, this is Maria Berrocal signing off from Clinical Minute.