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Published on: March 14, 2017
Ocular Complications in Patients With Transfusion-Dependent Beta-Thalassemia Receiving Deferasirox: A Cross-Sectional
Abdolreza Medghalchi1, Azadeh Rajabzadeh Kanafi2, Yousef Alizadeh1
1Department of Eye, Eye Research Center, Amiralmomenin Hospital Guilan University of Medical Sciences Rasht Iran.
Background And Aims:
Transfusion-dependent beta-thalassemia is a chronic hematologic disorder necessitating lifelong blood transfusions and iron chelation therapy, which can lead to systemic and ocular complications. This study aimed to assess the frequency and characteristics of ocular complications in beta-thalassemia patients treated with deferasirox.
Methods:
In this cross-sectional study, 75 patients with transfusion-dependent beta-thalassemia receiving deferasirox for at least 1 year were evaluated. Demographic and clinical characteristics, including hemoglobin (Hb) and ferritin levels over 6 months, were collected. Comprehensive ophthalmological assessments included best corrected visual acuity (BCVA), refraction, slit-lamp, fundus examination, optical coherence tomography (OCT), and fundus autofluorescence (FAF). Data were analyzed using SPSS version 26, and the significance level was set at 0.05.
Results:
The mean age of the 75 patients was 27.8 ± 8.3 years, and 69.3% were female. The mean duration of deferasirox treatment was 53.6 ± 33.3 months at a daily dose of 24.1 ± 7.99 mg/kg. Mean Hb and ferritin levels were 8.99 ± 2.12 g/dL and 1419.8 ± 1218.6 ng/mL, respectively. Cataracts were identified in 7 of 75 patients (9.3%), with bilateral involvement in all affected patients. Ophthalmologic measurements were analyzed separately for each eye. BCVA showed a positive correlation with Hb in the right eye (ρ = 0.460, p < 0.001). Mean myopic refractive errors were -0.95 D in the right eye and -0.83 D in the left eye. With-the-rule astigmatism was the most frequent subtype, accounting for 68% of evaluated eyes. FAF, performed in 43 patients, identified angioid streaks and hyperautofluorescent changes. A significant association was observed between cylindrical refractive error and treatment duration in the left eye (p = 0.010), and between cylindrical refractive error and daily deferasirox dose in the right eye (p = 0.020).
Conclusion:
Ocular abnormalities were observed in patients with transfusion-dependent beta-thalassemia receiving deferasirox therapy. Longitudinal controlled studies are required to clarify the contribution of deferasirox to these findings.
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