Retinal abnormalities in children suffering from low hemoglobin levels
Keywords:Anemia, Venous tortuosity, Flame shaped hemorrhages, Dot blot hemorrhages, Sub hyaloid hemorrhages, Macular edema, Disc pallor
Background: Anemia is a major public health problem with total prevalence of 30%. It is one of the hematological disorders which can induce retinal changes that are due to retinal hypoxia that leads to nerve fiber layer infarction. Other change includes increased vascular permeability, venous stasis, angiospasm and increased blood viscosity.
Methods: This is the cross-sectional study that includes 230 children with age group of 1 to15 years having hemoglobin levels less than 10 gm/dl referred to eye OPD. Ocular examination was done which included-visual acuity, anterior segment, dilated fundus examination.
Results: Retinopathy was observed in 95% children of severe anemia and 84% children of moderate anemia. Common findings observed vascular changes, dot blot hemorrhages, flame shaped hemorrhages, sub hyaloids hemorrhages, disc pallor and macular edema.
Conclusions: Retinopathy is a frequent finding seen in moderate to severe anemic patients, as the retinal changes were found significantly in maximum patients, it is recommended that all anemic patients particular Hb less than 10 g/dl must undergo routine fundus examinations.
DeMaeyer EA, Adiels-Tegman M. The prevalence of anaemia in the world. World health statistics quarterly. 1985;38(3):302-16.
Sudhagandhi B, Sundaresan S, William WE, Prema A. Prevalence of anaemia in the school children of Kattankulathur, Tamil Nadu, India. Int J Nutri Pharmacol Neurol Dis. 2011;1(2):184.
Ngesa O, Mwambi H. Prevalence and risk factors of anaemia among children aged between 6 months and 14 years in Kenya. PLoS One. 2014;9(11):e113756.
Kumar A. A Prospective Cross-Sectional Study of Ocular Manifestations in Patients with Anemia. J Dental Med Sci. 2019;18(11):10-15.
Garg P, Agrawal A. Ocular manifestations in patients with anaemia. J Evid Based Med. Healthc. 2017;4(79):4646-9.
Carraro MC, Rossetti L, Gerli GC. Prevalence of retinopathy in patients with anaemia or thrombocytopenia. Eur j haematol. 2001;67(4):238-44.
Basak S. A case of anemic retinopathy. University J Surg Surg Spec. 2020;28;6(7).
Shaheen N, Wani JS, Nasti AR, Quadri MI. Ocular manifestations in anaemia-A clinical study. J K Practioner. 2005;12(3):128-30.
Holt JM, Gordon-Smith EC. Retinal abnormalities in diseases of the blood. Bri J ophthalmol. 1969;53(3):145.
Suresh K, Sampath R, Tanvi. Ocular manifestations in haematological disorders. Shri Ramchandra J Med. 2011;4(1):1-4.
Majji AB, Bhatia K, Mathai A. Spontaneous bilateral peripapillary, subhyaloid and vitreous haemorrhage with severe anaemia secondary to idiopathic thrombocytopenic purpura. Indian J Ophthalmol. 2010;58(3):234-6.