Novel retinal findings in β-thalassemia major: older age and higher ferritin level as the risk factors

King Hans Kurnia, Elvioza, Mohamad Sidik, Teny Tjitra Sari, Joedo Prihartono, Rita S. Sitorus

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Purpose: To investigate retinal changes in β-thalassemia major patients and identify their association with systemic risk factors. Methods: In this prospective study, 120 β-thalassemia major patients received complete ophthalmic examinations (best-corrected visual acuity, contrast sensitivity, color vision, and indirect ophthalmoscopy) and retinal imaging using color fundus photography and fundus autofluorescence imaging. Patients were grouped according to the presence of thalassemia-related retinal changes. The association between systemic risk factors (age, type and duration of iron chelator use, history of splenectomy, hemoglobin level, and ferritin level) and thalassemia-related retinal changes was investigated using logistic regression analysis. Results: Thalassemia-related retinal changes were identified in 36.7% of patients. Several distinct retinal changes were observed, including retinal refractile bodies in 10% of patients and retinal hemorrhage in 5.8% of patients. Fundus autofluorescence imaging showed abnormal patterns in 36.3% of patients with thalassemia-related retinal changes and 18.4% of patients without thalassemia-related retinal changes. Age (odds ratio [OR] = 1.10, 95% confidence interval [CI] 1.03–1.18) and ferritin level (OR 1.16, 95% CI 1.01–1.33) were associated with thalassemia-related retinal changes. Conclusion: Novel retinal changes were observed in β-thalassemia major patients. This study identified older age and higher ferritin level as risk factors for thalassemia-related retinal changes.

Original languageEnglish
Pages (from-to)2633-2641
Number of pages9
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Issue number9
Publication statusPublished - Sept 2021


  • Ferritin
  • Fundus autofluorescence imaging
  • Iron chelator
  • Retinal changes
  • β-Thalassemia major


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