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Retinal fiber layer thickness in children with thalessemia major and iron deficiency anemia
Adnan Aksoy1, Lokman Aslan, Murat Aslankurt
1Department of Ophthalmology, KSU Medical Faculty , 46050, Kahramanmaras, Turkey .
Insights
Children with thalassemia major show thinner retinal nerve fiber layers (RNFL) in all quadrants, while those with iron deficiency anemia show thinning in the inferior quadrant. RNFL thickness correlates with hemoglobin and ferritin levels.
Area of Science:
- Ophthalmology
- Pediatrics
- Hematology
Background:
- Thalassemia major (tha-major) and iron deficiency anemia (IDA) are common pediatric hematologic conditions.
- Ocular complications, including changes in the retinal nerve fiber layer (RNFL), can occur in these conditions.
- Assessing RNFL thickness may provide insights into the systemic effects of these anemias.
Purpose of the Study:
- To measure and compare peripapillary retinal nerve fiber layer (RNFL) thickness in children with thalassemia major, iron deficiency anemia, and healthy controls.
- To investigate the correlation between RNFL thickness and hematological parameters in these pediatric groups.
Main Methods:
- A comparative study involving 47 children with tha-major, 22 with IDA, and 35 healthy controls.
- Participants underwent a complete eye examination, including intraocular pressure measurement.
- Peripapillary RNFL thickness was measured using optical coherence tomography (OCT).
Main Results:
- Mean peripapillary RNFL thickness was significantly thinner in all quadrants for the tha-major group compared to controls and the IDA group (p < 0.01).
- The IDA group showed significantly thinner RNFL in the inferior quadrant compared to controls (p < 0.05).
- RNFL thickness positively correlated with hemoglobin (r=0.488; p < 0.001) and negatively with ferritin levels (r=-0.544; p < 0.001).
Conclusions:
- Peripapillary RNFL is thinner in children with thalassemia major and, to a lesser extent, in those with iron deficiency anemia.
- RNFL thinning is associated with hemoglobin and ferritin levels, highlighting a potential link between anemia severity and ocular microvasculature.
- RNFL thickness did not correlate with transfusion history or visual acuity in this cohort.
Purpose:
We aimed to measure peripapillary retinal nerve fiber layer (RNFL) thickness in children with thalassemia major (tha-major), children with iron deficiency anemia (IDA), and children in a healthy control group.
Materials And Methods:
A total of 47 children with tha-major and 22 children with IDA were selected from two pediatric hematology outpatient clinics as our experimental groups, while 35 healthy children were randomly selected from a primary school to act as a control group. After a complete eye examination was conducted and intraocular pressure measurements were obtained, RNFL measurements were performed using optical coherence tomography, and the information was recorded for statistical analysis.
Results:
The mean age of the participants was 9.65 ± 4.13 years in the tha-major group, 9.14 ± 2.53 years in the IDA group, and 9.13 ± 3.29 years in the control group, respectively, with no statistically significant difference among the three groups (p > 0.05). Mean peripapillary RNFL thickness was 119.38 ± 35.49 microns in the tha-major group, 184.00 ± 31.14 microns in the IDA group, and 187.73 ± 27.36 microns in the control group. It was significantly thinner in all quadrants in the tha-major group vs. the other two groups (p < 0.01), and in only the inferior quadrant in the IDA group (p < 0.05). Average RNLF thickness correlated positively with mean hemoglobin value (r = 0.488; p < 0.001) and negatively with mean ferritin level (r = -0.544; p < 0.001), but no correlations with mean number of transfusions and mean visual acuity were observed (p > 0.05).
Conclusion:
The study revealed that peripapillary RNFL is thinner in tha-major in all quadrants and in only the inferior quadrant in IDA. Thinning of the RNLF correlated with hemoglobin value and ferritin level, but not with number of transfusions and visual acuity.
