Ocular findings in ?-thalassemia

Poster Details

First Author: F.Akritidou GREECE

Co Author(s):    M. Karafiloglou   V. Antoniou   A. Lachanas   D. Mposvelis   A. Goula   D. Karamanis

Abstract Details

Purpose:

To study the ocular manifestations in patients with beta-thalassemia.

Setting:

General Hospital of Kavala, Kavala -Greece

Methods:

In this study, 14 beta-thalassemia patients between 25 and 61 years of age were enrolled. These patients are followed up at the Unit of ?-thalassemia of the General Hospital of Kavala. Six of them suffer from the intermedia form while eight patients suffer from thalassemia major. All these patients receive regularly blood transfusions, they all receive medications and they were recently treated with iron chelating agents. All the patients underwent a complete ocular examination which included evaluation of visual acuity, refractive control, examination at the slit-lamp, examination of the fundus, color perception, Amsler test. OCT was also performed and in one case fluoroangiography was done.

Results:

In 46% of patients was observed one or more ocular abnormalities. These abnormalities were observed in patients with both forms of beta thalassemia, major and intermedia. In 3 eyes (2 patients) angioid streaks was observed while lenticular opacities were the most common ocular finding (8 eyes out of 28). One patient presented an intense yellowish color of the sclera. In 3 patients we observed degeneration of the retinal pigment epithelium causing general fundus atrophy in both eyes. OCT confirmed the presence of epiretinal membrane causing vitreo-retinal traction in both eyes in 2 patients. A case of a patient should be mentioned as this patient presented in his right eye an important and sudden impairment of visual acuity (1,5/10), Amsler (+), metamorphopsia. Fundus examination, OCT and fluoroangiography confirmed the presence of angioid streaks, diffuse oedema and the presence of cystic areas at the macula. The patient received three intravitreous injections of Ranibizumab with an excellent response to that treatment (complete regression of the metamorphopsia – visual acuity: 5/10).

Conclusions:

Patients who suffer from ?-thalassemia frequently present ocular abnormalities due both to their condition and the consequent chronic anemia and to the treatment they receive (mainly multiple blood transfusions +/- medications, in particular iron chelating agents). This study concludes that regular ocular examination can aid in preventing, delaying or ameliorating the ocular complications of thalassemia and so is important and should not be neglected. FINANCIAL DISCLOSURE?: No