Optical Coherence Tomography Angiography Findings in beta-Thalassemia Patients in Two Age Groups

Purpose: beta-thalassemia major causes hypoxia, which affects the retinal nerve fiber layer (RNFL), causing apoptosis. The frequent blood transfusion in transfusion-dependent thalassemia (TDT) accumulates ferritin, causing more damage. Using Optical Coherence Tomography (OCT) and Optical Coherence Tomography Angiography (OCTA), we aim to compare these changes in Youngs and adults. Methods: In this cross-sectional non-randomized comparative study, 50 TDT patients were included: 28 were under 18 years (group1) and 22 were above 18 years (group2). They were subjected to hematological examination and ophthalmological examination, including OCT and OCTA. Then, the data were collected and analyzed. Results: There was a statistical difference between the age in both groups (p=0.01). The two groups did not differ in sex distribution as well (p=0.085). All hematological parameters showed fewer values in (group 2) with a statistically significant difference in Serum ferritin, showing a marked increasing difference. There was a statistical difference between all Macular parameters and peripapillary quadrantal RNFL thickness of both groups (except for the C/D ratio), with higher values in (group 1). A moderate or strong positive correlation was found between all retinal parameters except for the C/D ratio and Hb level. A moderate or strong positive correlation was found between all retinal parameters except for the C/D ratio and serum ferritin. Moreover, there was a moderate to strong negative correlation between all retinal parameters except for the C/D ratio and frequency of blood transfusion. Conclusion: patients above 18 years (group2) are more affected by more RNFL thinning and vascular density changes.