Title: Ocular Manifestations in Multi-Transfused Children with Beta Thalassemia Receiving Chelating Agents
Authors: Dr Shantala Arunkumar, Dr Ruchi Sood, Dr Latha G S
DOI: https://dx.doi.org/10.18535/jmscr/v7i12.69
Abstract
Purpose: To determine prevalence of ocular abnormalities in children with beta thalassemia and assess the ocular side effects of blood transfusion and iron chelating agents.
Methods: Cross sectional study undertaken over a period of one year among 30 β Thalassemia major patients from age group of 6 months to 18 years were taken. Full medical history, thorough physical examinations were done to all patients groups, and ophthalmological examination to determine the prevalence of ocular manifestations for all patient groups and to correlate these manifestations or changes with iron chelating agents. Ocular examination including near and distance visual acuity assessment with Snellen's charts, colour vision testing, external examination with diffuse illumination, slit-lamp examination, direct and indirect ophthalmoscopy, schrimer test for tear break up time and ocular biometry will be performed.
Results: In 30 patients (16 females and 14 males) with age ranging between 2 years to 18 years. The prevalence of ocular abnormalities was 40%, (12/30). Ocular changes seen included decreased visual acuity 50% (6/12), ocular surface disorder 23%(7/12),lenticular opacity 16.5% (2/12), blurred optic disc margins 16.5% (2/12) and dilatation and tortuosity of retinal vessels 33% (4/12), Retinal pigment epithelium mottling 8%(1/12). The mean serum ferritin and the number of blood transfusions received were higher in children with ocular findings than in those with no ocular manifestations.
Conclusion: Ocular findings in beta-thalassemia may correlate to the disease itself, iron overload or the chelating agents used.Children with beta-Thalassemia develop various eye problems and Ocular changes are attributed to the course and severity of the disease. Therefore, beta thalassemia children should be screened periodically to enable early detection and delay of ocular changes.
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