Impact of new chelating agents on ocular abnormalities in β-thalassemia major patients: a comparative study

Abstract

Objectives The objectives of this study were to assess ocular changes in β-thalassemia major patients who have received multiple transfusions and different chelating agents. Patients and methods A cross-sectional study of 90 β-thalassemia major patients from age group 14 to 24 years were selected as case group, and 90 age-matched and sex-matched healthy participants were considered as a control group. Full medical history and thorough physical examinations were done to all patient groups. Ocular examination, including visual acuity, refraction testing, slit-lamp examination, funduscopy, tonometry, perimetry, tear-breakup time test, and color-vision testing, was performed for all the participants. We computed the frequency and duration of blood transfusion, the mean serum ferritin level, pretransfusion hemoglobin concentration, the type, duration, and daily dose of chelation therapy for thalassemia patients based on their records. Results All thalassemic patients were asymptomatic, but abnormal ocular findings [dry eye (13.3%), cataract (10%), retinal changes (16.7%), color-vision deficiency (3.33%), ocular hypertension (6.67%), and visual acuity (8.88%)] were seen in 58.9% of thalassemic group. The prevalence of ocular abnormalities in the control group was 19.4%, which was significantly lower than that in thalassemia patients (P=0.000). No significant correlation was found between ocular abnormalities and mean serum ferritin level (P=0.627) and mean hemoglobin concentration (P=0.143). A positive correlation between the number of blood transfusions with the presence of ocular abnormalities was found to be statistically significant (P=0.005). Recommendations As life expectancy for β-thalassemia patients extends, regular ophthalmologic evaluation to detect early changes in their ocular system is recommended.