Retinal and choroidal microvascular changes were identified using optical coherence tomography angiography (OCTA) among children with beta-thalassemia before any changes in vision were evident, according to the results of a prospective study.
In this cross-sectional study, which was published in the journal International Ophthalmology, ophthalmic exams were conducted among 56 children with transfusion-dependent thalassemia (TDT), 14 children with thalassemia who were not transfusion dependent (NTDT), and 63 children without thalassemia.
OCTA was used to evaluate vessel density (VD) of the superficial capillary plexus, deep capillary plexus, radial peripapillary capillary network, choriocapillaris, and the foveal avascular zone area (FAZ).
Patients with NTDT demonstrated the lowest macula VD of superficial capillary plexus (P =.001) and peripapillary VD (P <.001), whereas patients with TDT demonstrated the highest.
Retinal thickness was lowest among patients with TDT, including for the macular (P =.013), fovea (P =.002), and parafoveal areas (P =.012), compared with patients with NTDT and children without thalassemia. The choroidal thickness was also thinner in the TDT group compared with the NTDT and control groups for the temporal (P <.001), foveal (P <.001), and nasal (P <.001) regions. The peripapillary retinal nerve fiber thickness was not significantly different between the groups.
Among patients with TDT, peripapillary VD (P =.010) and the peripapillary inferior hemisphere VD (P =.007) were significantly thinner after a blood transfusion compared with before. Retinal thickness of the fovea (P =.011) increased and the peripapillary retinal nerve fiber thickness decreased (P =.039) after a transfusion.
“Changes in retinal and choroidal microvascular structure can be observed in children with beta-thalassemia before visual loss or ophthalmological examination findings,” the authors concluded in their report.
Güvenç U, Ünlü N, Yarali HN, Özbek NY. Does thalassemia truly cause microvascular changes without us noticing? An optical coherence tomography angiography study of the children with beta‑thalassemia. Int Ophthalmol. Published online June 30, 2023. doi: 10.1007/s10792-023-02786-z