Choroidal Thickness Evaluation in a Transfusion-Dependent Beta-Thalassemia Greek Population

Foteini Tsapardoni; Olga E Makri; Vasileios Lazaris; Vassiliki Labropoulou; Spyridon Lygeros; Stylianos Mastronikolis; Alexandra Kouraklis; Argiris Symeonidis; Constantinos D Georgakopoulos

doi:10.2147/OPTH.S285312

Choroidal Thickness Evaluation in a Transfusion-Dependent Beta-Thalassemia Greek Population

Clin Ophthalmol. 2020 Dec 24:14:4511-4518. doi: 10.2147/OPTH.S285312. eCollection 2020.

Authors

Foteini Tsapardoni¹, Olga E Makri¹, Vasileios Lazaris², Vassiliki Labropoulou², Spyridon Lygeros³, Stylianos Mastronikolis¹, Alexandra Kouraklis², Argiris Symeonidis², Constantinos D Georgakopoulos¹

Affiliations

¹ Department of Ophthalmology, University Hospital of Patras, Patras, Greece.
² Hematology Division, Department of Internal Medicine, University Hospital of Patras, Patras, Greece.
³ Medical School, University of Patras, Patras, Greece.

Abstract

Purpose: To evaluate choroidal thickness in a group of beta-thalassemia patients as assessed by enhanced depth imaging optical coherence tomography.

Patients and methods: This single-center, observational study involved transfusion-dependent beta-thalassemia (TD-β-thal) patients and healthy controls. One eye of each participant was included in the study. Submacular and peripapillary choroidal thickness, as well as central macular thickness and retinal nerve fiber layer thickness, were evaluated.

Results: Thirty-eight TD-β-thal patients (mean age 42 ± 10.7 years) and 22 healthy controls (mean age 40.3 ± 10.2 years) were included in the study. Subfoveal choroidal thickness was 297.4 ± 74.5 μm in the patient group and 358.4 ± 71.4 μm in the control group (p=0.003). Overall, in the submacular area, the choroid was found to be significantly thinner in the beta-thalassemia population compared to controls in all evaluated points, except for the spot located 1500 μm nasally to the fovea (p=0.093). In the peripapillary area, choroidal thickness was also significantly lower in the thalassemic population compared to the controls (nasal p=0.033, temporal p=0.01, superior p=0.01), except for the inferior quadrant (p= 0.191). We did not observe statistically significant differences in the retinal nerve fiber layer thickness and the central macular thickness between the two groups (p=0.658 and p=0.276, respectively). No correlations with hemoglobin, serum ferritin or iron levels emerged. Patients with the intermediate subtype appeared to have significantly thinner choroids than the ones with thalassemia major.

Conclusion: Our findings suggest that choroidal thickness in the submacular and peripapillary area is significantly reduced in thalassemic patients, compared to healthy individuals. Choroidal thinning in beta-thalassemia possibly reflects the effect of chronic anemia and underlying hemodynamic changes on choroidal tissue.

Keywords: central macular thickness; erythrocyte transfusion; iron chelation treatment; retinal nerve fiber layer thickness.