Ocular Findings Among Thalassemia Patients

Purpose:To study the ocular manifestations in multiple transfused beta-thalassemia major patients and assess the ocular side-effects of iron chelating agents.Materials and Methods:In this prospective observational study, 45 multiple transfused beta-thalassemia major children between six months and 21 years of age were enrolled and assigned groups according to the treatment regimens suggested. Group A received only blood transfusions, Group B blood transfusions with subcutaneous desferrioxamine, Group C blood transfusions with desferrioxamine and oral deferriprone and Group D blood transfusions with deferriprone. Ocular status at the time of enrolment was documented. Subjects were observed quarterly for one year for changes in ocular status arising due to the disease process and due to iron chelation therapy. Children with hemoglobinopathies other than beta-thalassemia major, congenital ocular anomalies and anemia due to other causes were excluded.Results:Ocular involvement was observed in 58% of patients. Lenticular opacities were the most common ocular finding (44%), followed by decreased visual acuity (33%). An increased occurrence of ocular changes was observed with increase of serum ferritin and serum iron levels as well as with higher number of blood transfusions received. Desferrioxamine seemed to have a protective influence on retinal pigment epithelium (RPE) mottling. Occurrence of lenticular opacities and RPE degeneration correlated positively with use of desferrioxamine and deferriprone respectively. Follow-up of patients for one year did not reveal any change in ocular status.Conclusion:Regular ocular examinations can aid in preventing, delaying or ameliorating the ocular complications of thalassemia.

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“…Recent studies conducted by Taher et al . [14] in 2006 have found normal visual acuity in 80.6% subjects. Taher et al .…”

Section: Discussionmentioning

confidence: 98%

Multiple transfused thalassemia major: Ocular manifestations in a hospital-based population

Taneja

Malik

Sharma

et al. 2010

Indian J Ophthalmol

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“…1,2 Other changes, including optic neuropathy and decreased visual acuity, have been linked to the use of deferoxamine. 1,3 Although optic neuropathy and retinal toxicity are known complications of deferoxamine, there is no report of any ocular complication after deferiprone, an oral substitute for deferoxamine. In this article, we report two cases of posterior subcapsular (PSC) deposits after consumption of oral deferiprone.…”

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confidence: 99%

Posterior subcapsular opacity in two patients with thalassaemia major following deferiprone consumption

Mehdizadeh

Nowroozzadeh

2009

Clinical and Experimental Optometry

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“…Decreased Visual acuity was also observed in other studies from15.5% to 30% of the children, our study also had similar range. 6,7 In our study, corneal dryness with BUT <10 sec was found in 13.3% of the children. When comparing the S. ferritin level with eye changes, only Iris changes were statistically significant in our study (p=0.001).…”

Section: Discussionmentioning

confidence: 89%

“…3,5 Retina was the most commonly affected part, ranging from 78.6% to 16.6%. 7,8 In our study 32% of the children had retinal changes like, degeneration of retinal pigmentary epithelium, retinal venous engorgement, vessel tortuosity and angioid streaks with decreased visual acuity. This has been observed in other studies also.…”

Section: Discussionmentioning

confidence: 99%

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Ocular involvement in beta thalassemia major: a prospective study in an Indian cohort

Kumble

Sekhon

Devi

2017

Int J Contemp Pediatr

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Background: Thalassemia is the commonest haemoglobinopathies worldwide. Repeated blood transfusions lead to hemosiderosis which affects all the organs in the body including eyes. This study aims to study Ocular manifestations in these children and its correlation with age and serum Ferritin level.Methods: 75 children diagnosed with B-Thalassemia major (BTM) and on regular transfusions underwent detailed Ocular examination between 2013 and 2015, including visual acuity, slit lamp bio microscopy, direct & indirect Opthalmoscopy).Results: Mean age for children was 9.73 years, with 77 % males and 23% females. Average S. Ferritin being 2701.96 ng/dl. The most common eye changes seen were in the Retina (32%, n=24), Iris (34.7%, n=26) and lens (32%, n=24). Retinal changes were temporal Retinal thinning (29.3%, n=22), retinal venous engorgement (21.3%, n=16), vessel tortuosity (17.3%, n=13), atrophy of disc (17.3%, n=13). Lens opacities were seen in 32 %, posterior sub capsular haze, streaks in posterior capsule, and heterochromia in 34.7%. Retinal changes correlated with duration of disease in children above 10 years and with increasing Serum Ferritin levels.Conclusions: Corneal dryness, lenticular opacities, disc atrophy and thinning were observed in children with B- Thalassemia and on blood transfusions. These changes increased with duration of disease. Hence there is need to screen BTM adolescents and follow up.

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Ocular Findings Among Thalassemia Patients

Cited by 38 publications

References 3 publications

Multiple transfused thalassemia major: Ocular manifestations in a hospital-based population

Multiple transfused thalassemia major: Ocular manifestations in a hospital-based population

Posterior subcapsular opacity in two patients with thalassaemia major following deferiprone consumption

Ocular involvement in beta thalassemia major: a prospective study in an Indian cohort

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