Περίληψη:
Purpose: The purpose of this study was to assess the role of various diagnostic tests in early detection of retinal changes in β-thalassemia major patients. Methods: Thirty-eight visually asymptomatic β-thalassemia major patients receiving regular blood transfusions and iron-chelation therapy with deferoxamine (group A, n = 13), deferasirox (group B, n = 11) or deferoxamine with deferiprone (group C, n = 14) and fourteen age- and sex- matched healthy individuals were included in the study. All participants underwent ophthalmoscopy, full-field electroretinography (ERG), visual evoked potentials (VEP), multifocal electroretinography (mfERG), fundus autofluorescence (FAF) imaging and optical coherence tomography (OCT) scans. Results: Retinal pigment epithelium changes were present in two cases. Scotopic ERG demonstrated decreased a-wave amplitude in groups A, B and C (p = 0.03, p = 0.002 and p = 0.002, respectively) and decreased b-wave amplitude in groups B and C (p = 0.002 and p = 0.01, respectively) compared to controls. Photopic ERG showed delayed b-wave latency in groups A and C (p = 0.03 and p = 0.03, respectively) ERG maximal combined response and VEP response did not differ between groups. MfERG showed reduced retinal response density in ring 1 in groups A, B, C (p < 0.001, p < 0.001, p = 0.001, respectively) and ring 2 in group B (p = 0.02) and delayed latency in ring 5 in groups A and B (p = 0.04 and p = 0.04, respectively). Abnormal FAF images appeared in three cases and OCT abnormalities in one case, whereas no changes were observed in controls (p = 0.55 and p = 1.00, respectively). Conclusions: Full-field ERG and mfERG are more sensitive tools for detecting early retinal changes in β-thalassemia patients compared with ophthalmoscopy, VEP, FAF imaging and OCT scans. © 2017, Springer-Verlag Berlin Heidelberg.
Συγγραφείς:
Dettoraki, M.
Kattamis, A.
Ladas, I.
Maragkos, K.
Koutsandrea, C.
Chatzistefanou, K.
Laios, K.
Brouzas, D.
Moschos, M.M.
Λέξεις-κλειδιά:
deferasirox; deferiprone; deferoxamine, A wave; adult; angioid streak; Article; autofluorescence imaging; B wave; beta thalassemia; blood transfusion; chelation therapy; clinical article; confocal scanning laser ophthalmoscope; controlled clinical trial; controlled study; electroretinography; eye toxicity; female; fundus autofluorescence; human; imaging system; latent period; male; multifocal electroretinography; ophthalmoscopy; optical coherence tomography; optical coherence tomography device; priority journal; retina pigment degeneration; retinal pigment epithelium; thalassemia major; visual evoked potential; beta thalassemia; complication; diagnostic imaging; early diagnosis; electroretinography; eye fundus; fluorescence angiography; middle aged; ophthalmoscopy; optical coherence tomography; pathophysiology; procedures; retina; retina disease; visual acuity; visual evoked potential, Adult; beta-Thalassemia; Early Diagnosis; Electroretinography; Evoked Potentials, Visual; Female; Fluorescein Angiography; Fundus Oculi; Humans; Male; Middle Aged; Ophthalmoscopy; Retina; Retinal Diseases; Tomography, Optical Coherence; Visual Acuity
