Ocular Involvement in Transfusion Dependent Thalassemia Children.

Abstract

Thalassemia is one of the most common haemoglobinopathies in the world. Transfusion dependent thalassemia patients need regular blood transfusion. Repeated blood transfusions lead to iron overloads which can affect various organs in the body including eyes. The present study aims to evaluate the ocular involvements in transfusion dependent thalassemia children and their relationship with duration of the disease and serum ferritin level. This cross-sectional observational study included 46 multi-transfused thalassemia children aged 3-18 years. Detailed ophthalmological examination including visual acuity, slit lamp bio microscopy, direct and indirect ophthalmoscopy was done. Statistical analysis was done using SPSS version (IBM) 23.0. Student's t-test and chi-square (χ²) test was done and p value of <0.05 was considered significant. Out of 46 thalassemia children male were 25(54.3%) and female were 21(45.7%). Mean age of the children was 8.94±5.04 years, mean duration of disease was 7.02±3.5 years and mean serum ferritin level 1543.68±914.43ng/dl. Ocular involvements were detected in 19(41.3%) children. Among them 8(17.39%) children had more than one ocular involvements. The ocular manifestations were decreased visual acuity in 17(36.95%), corneal dryness in 7(15.21%), lens opacity in 6(13.04%), optic disc atrophy in 7(15.21%), peripheral retinal pigmentation in 5(10.86%) and retinal vessels tortuosity in 3(6.52%) children. Higher serum ferritin level and increased duration of the disease were significantly (p<0.001) related with ocular involvement. Various ocular involvements were found in transfusion dependent thalassemia children. Therefore, transfusion dependent thalassemia children should be screened periodically for early detection and proper management of ocular changes.