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ORIGINAL ARTICLE
Year : 2010  |  Volume : 58  |  Issue : 2  |  Page : 125-130

Multiple transfused thalassemia major: Ocular manifestations in a hospital-based population


Departments of Ophthalmology and Pediatrics, Din Dayal Upadhyay Hospital, Hari Nagar, New Delhi - 110 064, India

Correspondence Address:
Mahesh C Agarwal
Din Dayal Upadhyay Hospital, Hari Nagar, New Delhi - 110 064, Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.60083

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Purpose: To study the ocular manifestations in multiple transfused beta-thalassemia major patients and assess the ocular side-effects of iron chelating agents. Materials and Methods: In this prospective observational study, 45 multiple transfused beta-thalassemia major children between six months and 21 years of age were enrolled and assigned groups according to the treatment regimens suggested. Group A received only blood transfusions, Group B blood transfusions with subcutaneous desferrioxamine, Group C blood transfusions with desferrioxamine and oral deferriprone and Group D blood transfusions with deferriprone. Ocular status at the time of enrolment was documented. Subjects were observed quarterly for one year for changes in ocular status arising due to the disease process and due to iron chelation therapy. Children with hemoglobinopathies other than beta-thalassemia major, congenital ocular anomalies and anemia due to other causes were excluded. Results: Ocular involvement was observed in 58% of patients. Lenticular opacities were the most common ocular finding (44%), followed by decreased visual acuity (33%). An increased occurrence of ocular changes was observed with increase of serum ferritin and serum iron levels as well as with higher number of blood transfusions received. Desferrioxamine seemed to have a protective influence on retinal pigment epithelium (RPE) mottling. Occurrence of lenticular opacities and RPE degeneration correlated positively with use of desferrioxamine and deferriprone respectively. Follow-up of patients for one year did not reveal any change in ocular status. Conclusion: Regular ocular examinations can aid in preventing, delaying or ameliorating the ocular complications of thalassemia.


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