Ocular abnormalities in multi‑transfused beta‑thalassemia patients.
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Date
2015-09
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Abstract
Aims: The aim of this study was to assess ocular changes in thalassemia patients who have
received multiple transfusions and chelate binding therapy in order to avoid iron accumulation.
Settings and Design: A cross‑sectional study. Subjects and Methods: A total of 54 thalassemia major
patients were selected as case group, and 54 age‑ and sex‑matched healthy subjects were regarded as
a control group. Ocular examination included visual acuity, refraction testing, slit lamp examination,
funduscopy, tonometry, perimetry, tear break‑up time test, and color vision testing were performed for all
the participants. We computed the frequency and duration of blood transfusion, the mean serum ferritin
level, pretransfusion hemoglobin concentration, and type, duration, and daily dose of chelation therapy
for thalassemia patients based on their records. Statistical Analysis Used: All data analysis was performed
using SPSS, version 19. Results: All the thalassemic patients were asymptomatic, but abnormal ocular
findings (dry eye (33.3%), cataract (10.2%), retinal pigment epithelium degeneration (16.7%), color vision
deficiency (3.7%), and visual field defects (33.7%)) were seen in 68.5% of thalassemic group. The prevalence
of ocular abnormalities in normal group was 19.4%, which was significantly lower than that in thalassemia
patients (P = 0.000). No significant correlation was found between ocular abnormalities and mean serum
ferritin level (P = 0.627) and mean hemoglobin concentration (P = 0.143). Correlation of number of blood
transfusion with the presence of ocular abnormalities was found to be statistically significant (P = 0.005).
Conclusions: As life expectancy for beta‑thalassemia patients extends, regular ophthalmological evaluation
to detect early changes in their ocular system is recommended.
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Keywords
Beta‑thalassemia major, blood transfusion, chelation therapy, ferritin, ocular abnormality
Citation
Jafari Reza, Heydarian Samira, Karami Hosein, Shektaei Mohammad Momeni, Dailami Kiumars Noruzpour, Amiri Ahmad Ahmadzadeh, Rezaee Majid Reza Sheikh, Far Asad Allah Farrokh. Ocular abnormalities in multi‑transfused beta‑thalassemia patients. Indian Journal of Ophthalmology. 2015 Sept; 63(9): 710-715.