.: ORİJİNAL ARAŞTIRMA
The Cross-Sectional Case-Control Integrated Analysis of Vitreous Chamber Length, Corneal Volume, and Globe Biometry in Pediatric Beta-Thalassemia Major
Pediatrik Beta-Talasemi Majörde Vitreus Kamara Uzunluğu, Korneal Hacim ve Glob Biyometrisinin Kesitsel Vaka Kontrollü Entegre Analizi
Turkiye Klinikleri J Ophthalmol. 2023;32(1):52-9
doi: 10.5336/ophthal.2022-93829
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: To determine ocular changes, particularly in vitreous chamber length (VCL) and corneal volume (CV), analyze globe biometric features in emmetrope pediatric beta-thalassemia major (βTM) patients using Cirrus topography and IOLMaster devices, and compare the results to age- and gender-matched healthy individuals. Material and Methods: This cross-sectional case-control study included 36 multi-transfused β-TM patients (Group 1, 72 eyes) with a mean age of 9.18±3.14 years and no other hemoglobinopathies or anemias unrelated to β-TM. A control group (Group 2, 72 eyes) included 36 healthy children who had routine ophthalmology exams. A comprehensive ophthalmologic exam was performed, including auto-refraction, best-corrected visual acuity, and intraocular pressure (IOP), followed by dilated slit-lamp biomicroscopy. The corneal topography and globe biometric evaluation were followed by a pair-wise data comparison. Results: The axial length (AL) (22.58±0.64 vs 23.06±0.71 mm), VCL (15.48±0.68 vs 15.92±0.69 mm), CV (55.47±2.95 vs 57.65±2.83 mm3), IOP (12.68±2.34 vs 11.08±1.68 mmHg), keratometry values (K1, K2, Kmean, Kapex), as well as central corneal thickness (523.00±28.41 vs 547.29±26.45 μm), were all significantly different between groups 1 and 2, respectively (p0.05). Conclusion: β-TM patients appear to have significant ocular growth retardation than relatively age-matched healthy children, as demonstrated by shorter AL and VCL, as well as lower CV. This circumstance could have prompted compensatory biometric modifications, as evidenced by a relatively steeper cornea and thicker crystalline lens, to accomplish emmetropization.
Keywords: Beta-thalassemia major; corneal topography; corneal volume; globe biometry; vitreous chamber length
Objective: To determine ocular changes, particularly in vitreous chamber length (VCL) and corneal volume (CV), analyze globe biometric features in emmetrope pediatric beta-thalassemia major (βTM) patients using Cirrus topography and IOLMaster devices, and compare the results to age- and gender-matched healthy individuals. Material and Methods: This cross-sectional case-control study included 36 multi-transfused β-TM patients (Group 1, 72 eyes) with a mean age of 9.18±3.14 years and no other hemoglobinopathies or anemias unrelated to β-TM. A control group (Group 2, 72 eyes) included 36 healthy children who had routine ophthalmology exams. A comprehensive ophthalmologic exam was performed, including auto-refraction, best-corrected visual acuity, and intraocular pressure (IOP), followed by dilated slit-lamp biomicroscopy. The corneal topography and globe biometric evaluation were followed by a pair-wise data comparison. Results: The axial length (AL) (22.58±0.64 vs 23.06±0.71 mm), VCL (15.48±0.68 vs 15.92±0.69 mm), CV (55.47±2.95 vs 57.65±2.83 mm3), IOP (12.68±2.34 vs 11.08±1.68 mmHg), keratometry values (K1, K2, Kmean, Kapex), as well as central corneal thickness (523.00±28.41 vs 547.29±26.45 μm), were all significantly different between groups 1 and 2, respectively (p0.05). Conclusion: β-TM patients appear to have significant ocular growth retardation than relatively age-matched healthy children, as demonstrated by shorter AL and VCL, as well as lower CV. This circumstance could have prompted compensatory biometric modifications, as evidenced by a relatively steeper cornea and thicker crystalline lens, to accomplish emmetropization.
Keywords: Beta-thalassemia major; corneal topography; corneal volume; globe biometry; vitreous chamber length
ÖZET
Amaç: Emetrop pediatrik beta-talasemi majör (β-TM) hastalarında vitreus kamara uzunluğu (VKU) ve korneal hacim (KH) başta olmak üzere oküler değişikliklerin Cirrus topografisi ve IOLMaster cihazlarıyla belirlenmesi, glob biyometrik özelliklerinin analiz edilmesi, sonuçlarının yaş ve cinsiyet uyumlu sağlıklı bireylerle karşılaştırılması. Gereç ve Yöntemler: Bu kesitsel vaka-kontrol çalışmasına, ortalama yaşı 9,18±3,14 olan ve β-TM ile ilişkili başka hemoglobinopati veya anemi olmayan 36 çoklu transfüze β-TM hastası (Grup 1, 72 göz) dâhil edildi. Kontrol grubu (Grup 2, 72 göz) rutin oftalmoloji muayenesi olan 36 sağlıklı çocuğu içeriyordu. Oto-refraksiyon, en iyi düzeltilmiş görme keskinliği ve göz içi basıncı (GİB) dâhil olmak üzere kapsamlı bir oftalmolojik muayene ve ardından dilate yarık lamba biyomikroskopisi yapıldı. Korneal topografi ve glob biyometrik değerlendirmesini ikili veri karşılaştırması takip etti. Bulgular: Aksiyel uzunluk (AU) (22,58±0,64 vs 23,06±0,71 mm), VKU (15,48±0,68 vs 15,92±0,69 mm), KH (55,47±2,95 vs 57,65±2,83 mm3), GİB (12,68±2,34 vs 11,08±1,68 mmHg), keratometri değerleri (K1, K2, Kmean, Kapex) ve santral korneal kalınlık (523,00±28,41 vs 547,29±26,45 μm), sırasıyla Grup 1 ve 2 arasında anlamlı olarak farklıydı (p0,05). Sonuç: β-TM hastaları, daha kısa AU ve VKU ve ayrıca daha düşük KH ile gösterildiği gibi nispeten aynı yaştaki sağlıklı çocuklara göre önemli oküler büyüme geriliğine sahip görünmektedir. Bu durum, emetropizasyonu gerçekleştirmek için nispeten daha dik bir kornea ve daha kalın lens ile kanıtlandığı gibi telafi edici biyometrik modifikasyonlarıyla ilişkili olabilir.
Anahtar Kelimeler: Beta-talasemi majör; korneal topografi; korneal hacim; glob biyometrisi; vitreus kamara uzunluğu
Amaç: Emetrop pediatrik beta-talasemi majör (β-TM) hastalarında vitreus kamara uzunluğu (VKU) ve korneal hacim (KH) başta olmak üzere oküler değişikliklerin Cirrus topografisi ve IOLMaster cihazlarıyla belirlenmesi, glob biyometrik özelliklerinin analiz edilmesi, sonuçlarının yaş ve cinsiyet uyumlu sağlıklı bireylerle karşılaştırılması. Gereç ve Yöntemler: Bu kesitsel vaka-kontrol çalışmasına, ortalama yaşı 9,18±3,14 olan ve β-TM ile ilişkili başka hemoglobinopati veya anemi olmayan 36 çoklu transfüze β-TM hastası (Grup 1, 72 göz) dâhil edildi. Kontrol grubu (Grup 2, 72 göz) rutin oftalmoloji muayenesi olan 36 sağlıklı çocuğu içeriyordu. Oto-refraksiyon, en iyi düzeltilmiş görme keskinliği ve göz içi basıncı (GİB) dâhil olmak üzere kapsamlı bir oftalmolojik muayene ve ardından dilate yarık lamba biyomikroskopisi yapıldı. Korneal topografi ve glob biyometrik değerlendirmesini ikili veri karşılaştırması takip etti. Bulgular: Aksiyel uzunluk (AU) (22,58±0,64 vs 23,06±0,71 mm), VKU (15,48±0,68 vs 15,92±0,69 mm), KH (55,47±2,95 vs 57,65±2,83 mm3), GİB (12,68±2,34 vs 11,08±1,68 mmHg), keratometri değerleri (K1, K2, Kmean, Kapex) ve santral korneal kalınlık (523,00±28,41 vs 547,29±26,45 μm), sırasıyla Grup 1 ve 2 arasında anlamlı olarak farklıydı (p0,05). Sonuç: β-TM hastaları, daha kısa AU ve VKU ve ayrıca daha düşük KH ile gösterildiği gibi nispeten aynı yaştaki sağlıklı çocuklara göre önemli oküler büyüme geriliğine sahip görünmektedir. Bu durum, emetropizasyonu gerçekleştirmek için nispeten daha dik bir kornea ve daha kalın lens ile kanıtlandığı gibi telafi edici biyometrik modifikasyonlarıyla ilişkili olabilir.
Anahtar Kelimeler: Beta-talasemi majör; korneal topografi; korneal hacim; glob biyometrisi; vitreus kamara uzunluğu
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