Fig. 8. A 27-year-old woman with homozygous sickle cell anemia and stage III sickle cell retinopathy. A. Three days after scatter photocoagulation to the right eye, a photograph of the right eye shows retinal arteriolar occlusions causing a white, edematous macula, a cherry red spot, and a cotton-wool spot superior to the macula. B. Fluorescein angiogram clearly shows the occluded arteriole superiorly, but no occlusion in the perifoveal or temporal macula. C. However, a fluorescein angiogram taken 1 year later demonstrates an irregular perifoveal capillary network with areas of capillary nonperfusion (arrows). D. Of interest, the left eye simultaneously developed an area of capillary nonperfusion, demonstrated by a cotton-wool spot nasal to the fovea. E. Two years later, there is resolution of the cotton-wool spot in the left eye, but a retinal depression sign remains, as demonstrated by an abnormal light reflex in the area nasal to the fovea (arrows).