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Relation of anthropometric measurements to ocular biometric changes and refractive error in children with thalassemia
Rania S Elkitkat1, Amany A El-Shazly1, Weam M Ebeid1
11 Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo - Egypt.
Insights
Children with thalassemia major show stunted growth and ocular development, leading to a myopic shift. Despite compensatory eye changes, overall growth retardation is not directly linked to these visual impairments.
Area of Science:
- Pediatric Ophthalmology
- Genetics and Inherited Diseases
- Growth and Development Disorders
Background:
- Thalassemia major (TM) is a genetic blood disorder requiring lifelong treatment.
- Understanding its impact on physical and ocular development is crucial for comprehensive patient care.
Purpose of the Study:
- To evaluate and correlate anthropometric, biometric, and refractive error changes in children with thalassemia major.
- To investigate the relationship between general growth and ocular development in TM patients.
Main Methods:
- A comparative study involving 100 children with TM and 100 healthy controls.
- Anthropometric measurements (height, weight, BMI, OFC) and comprehensive ophthalmologic examinations were performed.
- Ocular biometry, including keratometry and axial length, and cycloplegic refraction were assessed.
Main Results:
- Children with TM exhibited significantly shorter stature, lower weight, and smaller BMI compared to controls.
- TM patients showed steeper corneal readings, shorter axial length, shallower vitreous chamber, and thicker lenses.
- A significant myopic shift was observed in children with thalassemia major.
Conclusions:
- Children with TM experience significant retardation in both general and ocular growth.
- Compensatory ocular changes, such as steeper corneas and thicker lenses, may contribute to a myopic shift.
- Growth retardation in TM is not directly correlated with ocular growth, refractive error, or biometric parameter variations.
Purpose:
To evaluate and correlate anthropometric, biometric, and refractive error changes in thalassemia major (TM).
Methods:
One hundred children with TM and another hundred healthy controls were recruited. Height, weight, body mass index (BMI), and occipitofrontal circumference (OFC) were the anthropometric parameters recorded. Full ophthalmologic examination was performed, including best-corrected visual acuity, cycloplegic refraction, slit-lamp examination, Goldmann applanation tonometry, indirect ophthalmoscopy, keratometry (K readings), and ocular biometry.
Results:
Compared to controls, children with TM were shorter and lighter, with a smaller BMI (p<0.001); however, no significant difference existed in OFC. Regarding ocular biometric data, patients with thalassemia had steeper mean K readings (p = 0.03), shorter axial length (AXL) (p = 0.005), shorter vitreous chamber depth (p<0.001), and thicker crystalline lens (p<0.001) than controls. Patients with thalassemia had a significant myopic shift (p = 0.003). Multiple regression analyses only showed a significant correlation between corneal astigmatism and both weight and height (β = -0.05 and p = 0.03 and β = 0.06 and p = 0.04, respectively). Spherical equivalent was significantly correlated to K readings, lens thickness, and anterior chamber depth (p<0.0001 for all parameters).
Conclusions:
Compared to controls, children with TM have significant retardation in general and ocular growth (smaller BMI and shorter AXL). Ocular growth changes probably resulted in compensatory biometric changes (steeper corneas and thicker lenses) to reach emmetropization, with an exaggerated response and subsequent myopic shift. However, growth retardation is not directly related to ocular growth changes, myopic shift, or variations in biometric parameters.
