Ocular Abnormalities in Children with Beta Thalassemia Major at a Tertiary Care Center

Worldwide many studies conducted on children with thalassemia have found that there is an increased incidence of ocular problems such as ocular surface disease, refractive errors, anterior segment abnormalities and an array of retinal abnormalities, ie, pseudoxanthoma (PXE) like retinal abnormalities and non PXE like retinal abnormalities which includes retinal venous tortousity (RVT) and choroidal thinning. In India there are not enough studies available regarding the ocular complications occurring in such patients, so we planned this study. This study was planned to assess the proportion of beta thalassemia patients having ocular abnormalities and the relationship of ocular abnormalities with duration of illness, number of blood transfusions received, type and duration of chelation therapy, serum ferritin levels and the mean pre-transfusion haemoglobin concentration. This was a hospital-based observational cross-sectional study which enrolled 60 children with beta thalassemia receiving blood transfusions and chelation therapy for at least 2 years and their age and sex matched healthy children. Each patient underwent a complete eye examination which included visual acuity, color vision testing, refractive measurement, slit lamp examination, tonometry, Schirmer-I test, fundoscopy and Optical Coherence Tomography. Differences in ocular parameters in both groups and their association with pre transfusion hemoglobin, ferritin levels, duration of illness, number of blood transfusions and duration of chelation therapy were measured. Nominal/categorical variables were summarized as frequency and percentage and were analyzed using the Chi square test. Continuous variables were summarized as mean and standard deviation and were analyzed using the t test for intra-group comparison. Univariate linear regression analysis was done to find out the correlation between ocular parameters with clinical and laboratory parameters. The variables found to be significant were then entered into multivariate regression analysis to determine the independent predictors. A p value < 0.05 was taken as statistically significant. All statistical analyses were done using SPSS trial version 20. Overall, the incidence of any ocular abnormality in children with thalassemia was 43.3%. There were significant differences in visual acuity and choroidal thickness with thinning of choroid in the case group. However, only mean pre transfusion hemoglobin was found to be significantly associated with decreased choroidal thickness at fovea. Children with beta thalassemia have ocular changes in the form of significantly decreased visual acuity and thinning of the choroid. It was found that choroidal thinness was positively correlated with the mean pre transfusion hemoglobin levels.

The online version contains supplementary material available at 10.1007/s12288-025-02071-2.