Nihat SAYIN, Gonul AYDOĞAN, Mehmet ERDOĞAN, Sadık Etka BAYRAMOĞLU, Dilbade YILDIZ EKİNCİ

Anterior segment parameters and tear functions in patients with thalassemia major

Aim: To determine whether the biomicroscopic, topographic and biomechanical properties of the anterior segment and the tearfunction have changed in Thalassemia Major (TM) patients.Material and Methods: Eighty-eight eyes of patients with TM and 102 eyes of healthy controls paired with age, gender, and sphericalequivalent were included in this cross- sectional case-control study. Biomicroscopic, topographic and biomechanical findings ofanterior segment and Schirmer test measurements were compared between the two groups.Results: The mean age was found to be 15.11±6.01years in TM group, and 13.83±4.92 years in the control group (p=0.17). In 34(38.63%) patients with TM, minor peripheral lens opacities were detected. Visual acuity was 20/20 in all patients with lens opacity.The mean iridocorneal angle (ICA) was 44.67±5.86 and the topographic anterior chamber depth (ACD) was 3.65±0.28 mm in the TMpatients. Mean ICA was 48.78 ± 6.51 and topographic ACD was 3.76±0.30 mm in the control group (p

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1. Cao A, Galanello R. Beta-thalassemia. Genet Med. 2010;12:61-76.
2. Rund D, Rachmilewitz E. Beta-thalassemia. N Engl J Med. 2005;353:1135-46. 3. Thein SL. The molecular basis of beta-thalassemia. Cold Spring Harb Perspect Med 2013;3:011700.
4. Aksoy A, Aslankurt M, Aslan L, et al. Ocular findings in children with thalassemia major in Eastern Mediterranean. Int J Ophthalmol 2014;7:118-21.
5. Bueno-Gimeno I, Gene-Sampedro A, Pinero-Llorens DP, et al. Corneal biomechanics, retinal nerve fiber layer, and optic disc in children. Optom Vis Sci 2014;91:1474-82.
6. Giardina P, Schneider R, Lesser M, et al. Abnormal bone metabolism in thalassemia. Endocrine Disorders in Thalassemia: Springer 1995.39-46.
7. Jensen CE, Tuck SM, Agnew JE, et al. High prevalence of low bone mass in thalassaemia major. Br J Haematol 1998;103:911-5.
8. Shamshirsaz AA, Bekheirnia MR, Kamgar M, et al. Metabolic and endocrinologic complications in beta-thalassemia major: a multicenter study in Tehran. BMC Endocr Disord 2003;3:4.
9. Nowroozzadeh MH, Kalantari Z, Namvar K, et al. Ocular refractive and biometric characteristics in patients with thalassaemia major. Clin Exp Optom 2011;94:361-6.
10. Wu CH, Yang CP, Lai CC, et al. Deferoxamine retinopathy: spectral domain-optical coherence tomography findings. BMC Ophthalmol 2014;14:88.
11. Gartaganis SP, Georgakopoulos CD, Exarchou A, et al. Alterations in conjunctival cytology and tear film dysfunction in patients with beta-thalassemia. Cornea 2003;22:591-7.
12. Taneja R, Malik P, Sharma M, et al. Multiple transfused thalassemia major: ocular manifestations in a hospitalbased population. Indian J Ophthalmol 2010;58:125-30.
13. Ghugre NR, Enriquez CM, Gonzalez I, et al. MRI detects myocardial iron in the human heart. Magn Reson Med 2006;56:681-6.
14. Anderson L, Holden S, Davis B, et al. Cardiovascular T2- star (T2*) magnetic resonance for the early diagnosis of myocardial iron overload. Eur Heart J 2001;22:2171-9.
15. Hankins JS, McCarville MB, Loeffler RB, et al. R2* magnetic resonance imaging of the liver in patients with iron overload. Blood 2009;113:4853-5.
16. Wood JC, Kang BP, Thompson A, et al. The effect of deferasirox on cardiac iron in thalassemia major: impact of total body iron stores. Blood 2010;116:537-43.
17. Livrea M, Tesoriere L, Pintaudi A, et al. Oxidative stress and antioxidant status in beta-thalassemia major: iron overload and depletion of lipid-soluble antioxidants. Blood 1996;88:3608-14.
18. Sultanov M, Gadzhieva NM. Ocular function in betathalassemia patients. Vestn Oftalmol 1992;108:42-5.
19. Repanti M, Gartaganis SP, Nikolakopoulou NM, et al. Study of the eye and lacrimal glands in experimental iron overload in rats in vivo. Anat Sci Int 2008;83:11-6.
20. Abdel-Malak DS, Dabbous OA, Saif MY, et al. Ocular manifestations in children with β thalassemia major and visual toxicity of iron chelating agents. J Am Sci 2012;8:633- 8.
21. Duval R, Olivier S. Intravitreal bevacizumab (avastin) for choroidal neovascularization associated with deferoxamine retinopathy. Retin Cases Brief Rep 2011;5:233-6.
22. Mehdizadeh M, Nowroozzadeh MH. Posterior subcapsular opacity in two patients with thalassaemia major following deferiprone consumption. Clin Exp Optom 2009;92:392-4.
23. Heydarian S, Jafari R, Karami H. Refractive errors and ocular biometry components in thalassemia major patients. Int Ophthalmol 2016;36:267-71.
24. Khalaj M, Mahyar A, Jahan Hashemi H, et al. Assessing the refractive errors in beta-thalassemia major patients. J Guilan Univers Med Sci 2009;17:42-9.
25. Athanasiadis I, Konstantinidis A, Kyprianou I, et al. Rapidly progressing bilateral cataracts in a patient with beta thalassemia and pellagra. J Cataract Refract Surg 2007;33:1659-61.
26. Jethani J, Marwah K, Nikul SP, et al. Ocular abnormalities in patients with beta thalassemia on transfusion and chelation therapy: our experience. Indian J Ophthalmol 2010;58:451.
27. Dewan P, Gomber S, Chawla H, et al. Ocular changes in multi-transfused children with β-thalassaemia receiving desferrioxamine: A case-control study.SAJCH 2011;5:11-4.
28. Voskaridou E, Terpos E. New insights into the pathophysiology and management of osteoporosis in patients with beta thalassaemia. Br J Haematol 2004;127:127-39.