DOI: 10.4103/ejos.ejos_19_26 ISSN: 2090-0686

Evaluation of retinal nerve fiber layer thickness by optical coherence tomography in patients with iron-deficiency anemia

Yasmina M.A. Ibrahim, Mohamed N. Elmohamady, Amira K. El-Alfy, Ehab M.E. Saad
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Background

Iron-deficiency anemia (IDA) can reduce systemic oxygen delivery and may contribute to retinal neurovascular compromise measurable as retinal nerve fiber layer (RNFL) thinning on optical coherence tomography.

Objectives

Our study aimed to asses peripapillary RNFL thickness by optical coherence tomography in patients with IDA and to examine associations between RNFL thickness and hematologic parameters.

Patients and methods

This cross-sectional case–contro1 study included 100 eyes from 50 adults examined at Benha University Hospital. Fifty eyes from 25 IDA patients [hemoglobin (Hb) ≤10 g/dl] were compared with 50 eyes from 25 age-matched and sex-matched controls (Hb ≥l3 g/dl in males and ≥l2 g/dl in females).

Results

Age and sex distribution, intraocular pressure, and best-corrected visual acuity were comparable between groups (all P >0.05). Average RNFL was significantly thicker in controls than IDA (OS: 109.2±3.4 vs. 88.4±6.6 μm; OD: 106.6±3.9 vs. 85.6±6.1 μm; P =0.001 for both), with significant thinning across inferior, superior, temporal, and nasal quadrants ( P ≤0.013). Average RNFL correlated positively with Hb ( r =0.854) and ferritin ( r =0.855), and inversely with red cell distribution width ( r =−0.867) and total iron-binding capacity ( r =−0.784) (all P =0.001).

Conclusions

IDA is associated with significant peripapillary RNFL thinning, and RNFL thickness relates closely to anemia severity and iron status indices.

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