Evaluation of Corneal and Lens Densitometry with Scheimpflug Imaging in Young Beta Thalassemia Patients

Year 2022, Volume: 5 Issue: 3, 387 - 394, 01.09.2022

Hafize Gökben Ulutaş , Elif Güler Kazancı

https://doi.org/10.19127/bshealthscience.1090525

Abstract

The aim of this study is to compare corneal and lens density of children with Beta (β) thalassemia and healthy controls using Pentacam HR. This is a case-control and cross-sectional study. Anterior segment parameters, corneal, and lens densitometry of patients with β-thalassemia and healthy controls were evaluated with Scheimpflug corneal topography. For corneal densitometry analysis, the 12 mm diameter area of the cornea was divided into four concentric radial zones and anterior, central, and posterior layers according to corneal depth. The mean densitometry value for the crystalline lens was calculated in three regions around the center of the pupil. Non-contact specular microscopy was used to examine the morphology of the corneal endothelium. The study group consisted of 32 β-thalassemia major patients and the control group consisted of 31 healthy volunteers. The mean age of the study group was 12.12±3.94 years (range: 5-19 years) and 10.90±3.84 years (range: 5-19 years) in the control group (P>0.05). Corneal light backscattering in the posterior layer was significantly lower in the patient group than in the control group. Corneal endothelial cell density was determined as 3053.55±189.71 in the patient group and 3214±195.12 in the control group (P=0.094). Lens densitometry values did not differ between the two groups (P>0.05). We detected changes in corneal densitometry examination without any clinical findings in patients with β-thalassemia major. Pentacam may be a suitable screening technique for early detection of β-thalassemia ocular signs in children. Prospective studies with a large number of cases are needed to support these findings.

Keywords

Beta thalassemia, Corneal densitometry, Lens densitometry, Corneal endothelium

References

• Athanasiadis I, Konstantinidis A, Kyprianou I, Robinson R, Moschou V, Kouzi-Koliakos K. 2007. Rapidly progressing bilateral cataracts in a patient with beta thalassemia and pellagra. J Cataract Refract Surg, 33(9): 1659-1661. DOI: 10.1016/j.jcrs.2007.05.011.
• Burren CP, Berka JL, Edmondson SR, Werther GA, Batch JA. 1996. Localization of mRNAs for insulin-like growth factor-I (IGF-I), IGF-I receptor, and IGF binding proteins in rat eye. Invest Ophthalmol Vis Sci, 37(7): 1459-1468.
• Consejo A, Alonso-Caneiro D, Wojtkowski M, Vincent SJ. 2020. Corneal tissue properties following scleral lens wear using Scheimpflug imaging. Ophthalmic Physiol Opt, 40(5): 595-606. DOI: 10.1111/opo.12710.
• Coşkun M, İlhan Ö, İlhan N, Tuzcu EA, Daglioğlu MC, Kahraman H, Helvaci MR. 2015. Changes in the cornea related to sickle cell disease: a pilot investigation. Eur J Ophthalmol, 25(6): 463-467. DOI: 10.5301/ejo.5000598.
• Demosthenous C, Vlachaki E, Apostolou C, Eleftheriou P, Kotsiafti A, Vetsiou E, Sarafidis P. 2019. Beta-thalassemia: renal complications and mechanisms: a narrative review. Hematology, 24(1): 426-438.
• Dereli Can G, Kara Ö. 2019. Noninvasive evaluation of anterior segment and tear film parameters and morphology of meibomian glands in a pediatric population with hypogonadism. Ocul Surf, 17(4): 675-682. DOI: 10.1016/j.jtos.2019.09.001.
• Dong J, Zhang Y, Zhang H, Jia Z, Zhang S, Sun B, Wang X. 2018. Corneal densitometry in high myopia. BMC Ophthalmol, 18(1): 182. DOI: 10.1186/s12886-018-0851-x.
• El-Haddad NS. 2020. Anterior chamber angle, intraocular pressure, and globe biometric parameters in the children with β-thalassemia major. J Curr Glaucoma Pract, 14(1): 30-36. DOI: 10.5005/jp-journals-10078-1274.
• Elkitkat RS, El-Shazly AA, Ebeid WM, Deghedy MR. 2018. Relation of anthropometric measurements to ocular biometric changes and refractive error in children with thalassemia. Eur J Ophthalmol, 28(2): 139-143. DOI: 10.5301/ejo.5000903.
• Heydarian S, Jafari R, Dailami KN, Hashemi H, Jafarzadehpour E, Heirani M, Khabazkhoob M. 2020. Ocular abnormalities in beta thalassemia patients: prevalence, impact, and management strategies. Int Ophthalmol, 40(2): 511-527. DOI: 10.1007/s10792-019-01189-3.
• Heydarian S, Jafari R, Karami H. 2016. Refractive errors and ocular biometry components in thalassemia major patients. Int Ophthalmol, 36(2): 267-271. DOI: 10.1007/s10792-015-0161-8.
• Jafari R, Heydarian S, Karami H, Shektaei MM, Dailami KN, Amiri AA, Far AA. 2015. Ocular abnormalities in multi-transfused beta-thalassemia patients. Indian J Ophthalmol, 63(9): 710-715. DOI: 10.4103/0301-4738.170986.
• Kadhim KA, Baldawi KH, Lami FH. 2017. Prevalence, Incidence, Trend, and Complications of Thalassemia in Iraq. Hemoglobin, 41(3): 164-168.
• Nowroozzadeh MH, Kalantari Z, Namvar K, Meshkibaf MH. 2011. Ocular refractive and biometric characteristics in patients with thalassaemia major. Clin Exp Optom, 94(4): 361-366. DOI: 10.1111/j.1444-0938.2010.00579.x.
• Origa R. 1993. Beta-Thalassemia. In M. P. Adam, H. H. Ardinger, R. A. Pagon, S. E. Wallace, L. J. H. Bean, G. Mirzaa, & A. Amemiya (Eds.), GeneReviews(®).University of Washington, Seattle, Seattle, WA, US.
• Otri AM, Fares U, Al-Aqaba MA, Dua HS. 2012. Corneal densitometry as an indicator of corneal health. Ophthalmology, 119(3): 501-508.
• Popescu C, Siganos D, Zanakis E, Padakis A. 1998. The mechanism of cataract formation in persons with beta-thalassemia. Oftalmologia, 45(4): 10-13.
• Repanti M, Gartaganis SP, Nikolakopoulou NM, Ellina A, Papanastasiou DA. 2008. Study of the eye and lacrimal glands in experimental iron overload in rats in vivo. Anat Sci Int, 83(1): 11-16. DOI: 10.1111/j.1447-073X.2007.00195.x.
• Shah R, Amador C, Tormanen K, Ghiam S, Saghizadeh M, Arumugaswami V, Ljubimov AV. 2021. Systemic diseases and the cornea. Exp Eye Res, 204: 108455.
• Smith GT, Brown NA, Shun-Shin GA. 1990. Light scatter from the central human cornea. Eye, 4(4): 584-588. DOI: 10.1038/eye.1990.81.
• Taneja R, Malik P, Sharma M, Agarwal MC. 2010. Multiple transfused thalassemia major: ocular manifestations in a hospital-based population. Indian J Ophthalmol, 58(2): 125-130. DOI: 10.4103/0301-4738.60083.