Retinal Nerve Fibre Layer Thinning in Patients with Thalassaemia, Iron Deficiency Anaemia, and Anaemia of Chronic Diseases

Abstract

Purpose. Retinal nerve fibre layer (RNFL) is a sensitive structure, which is affected by anaemia due to hypoxia. A timely detection of RNFL thinning may aid preventing devastating complications. Optical coherence tomography (OCT) measures RNFL thinning with accuracy and helps in detecting thinning of the retinal layer in anaemic patients. This study was destined to evaluate thinning of RNFL in anaemic patients and their correlation with the haemoglobin level. Methods. It was a prospective comparative study. Total of 151 patients were included in this study. Patients with retinal diseases were excluded from this study. After initial evaluation, haematological and ophthalmological parameters were measured. RNFL was measured with OCT and corroborated with the Hb level and analysed accordingly. EPI and SPSS softwares were used for detail analysis and the correlation between RNFL thinning and the Hb level. Initially, each eye was separately assigned a value (0, 1, and 2) (normal, borderline, and abnormal, respectively) as per the severity of thinning, and then, the sum of the scores of both eyes were considered as a separate variable, and a multiple linear regression analysis was performed with the independent variables. Results. RNFL thinning was found to be significant in each group of patients. There was a strong correlation of RNFL thinning with degree of anaemia. Conclusions. Thalassaemia, iron deficiency anaemia, and anaemia of chronic diseases are associated with the significant damage to RNFL. Degree of anaemia is the most important parameter for such thinning of the RNFL layer.

Peripapillary nerve fiber layer in patients with iron deficiency anemia: A cross-sectional study in a tertiary eye care center in Central India

“…We found a positive correlation between the average RNFLT and the serum hemoglobin, iron, ferritin, and transferrin level, which correlates with the findings of Datta et al . [ 26 ]…”

The relationship between optic disc-foveal distance with choroidal and retinal nerve fiber thickness

“…On the surface of the retina facing the corpus vitreum, the retinal nerve fiber layer (RNLF) is composed of bipolar and multipolar ganglion cell axons and their extensions and bipolar and cone cells that collect visual impulses. The RNLF is a delicate structure that can be affected by many causes such as high intraocular pressure, inflammation and vascular causes, resulting in fiber loss and atrophy of the optic nerve [7]. The choroid is a thin, vascular-rich layer inside the sclera, which forms most of the back of the eyeball and supplies blood to the retina, retinal pigment epithelium and optic nerve.…”