Erschienen in:
30.03.2017 | Retinal Disorders
Electrophysiological assessment for early detection of retinal dysfunction in β-thalassemia major patients
verfasst von:
Maria Dettoraki, Antonis Kattamis, Ioannis Ladas, Konstantinos Maragkos, Chryssanthi Koutsandrea, Klio Chatzistefanou, Konstantinos Laios, Dimitrios Brouzas, Marilita M. Moschos
Erschienen in:
Graefe's Archive for Clinical and Experimental Ophthalmology
|
Ausgabe 7/2017
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Abstract
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.