Novel retinal findings in β-thalassemia major: older age and higher ferritin level as the risk factors

Purpose To investigate retinal changes in β-thalassemia major patients and identify their association with systemic risk factors. Methods In this prospective study, 120 β-thalassemia major patients received complete ophthalmic examinations (best-corrected visual acuity, contrast sensitivity, color v...

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Published in:Graefe's archive for clinical and experimental ophthalmology 2021-09, Vol.259 (9), p.2633-2641
Main Authors: Kurnia, King Hans, Elvioza, Sidik, Mohamad, Sari, Teny Tjitra, Prihartono, Joedo, Sitorus, Rita S.
Format: Article
Language:English
Subjects:
Acuity
Blood diseases
Color vision
Ferritin
Hemoglobin
Hemorrhage
Medicine
Medicine & Public Health
Ophthalmology
Photography
Retina
Retinal Disorders
Risk factors
Splenectomy
Thalassemia
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Summary:Purpose To investigate retinal changes in β-thalassemia major patients and identify their association with systemic risk factors. Methods In this prospective study, 120 β-thalassemia major patients received complete ophthalmic examinations (best-corrected visual acuity, contrast sensitivity, color vision, and indirect ophthalmoscopy) and retinal imaging using color fundus photography and fundus autofluorescence imaging. Patients were grouped according to the presence of thalassemia-related retinal changes. The association between systemic risk factors (age, type and duration of iron chelator use, history of splenectomy, hemoglobin level, and ferritin level) and thalassemia-related retinal changes was investigated using logistic regression analysis. Results Thalassemia-related retinal changes were identified in 36.7% of patients. Several distinct retinal changes were observed, including retinal refractile bodies in 10% of patients and retinal hemorrhage in 5.8% of patients. Fundus autofluorescence imaging showed abnormal patterns in 36.3% of patients with thalassemia-related retinal changes and 18.4% of patients without thalassemia-related retinal changes. Age (odds ratio [OR] = 1.10, 95% confidence interval [CI] 1.03–1.18) and ferritin level (OR 1.16, 95% CI 1.01–1.33) were associated with thalassemia-related retinal changes. Conclusion Novel retinal changes were observed in β-thalassemia major patients. This study identified older age and higher ferritin level as risk factors for thalassemia-related retinal changes.
ISSN:0721-832X
1435-702X
DOI:10.1007/s00417-021-05141-z