Optical coherans tomography for the assessment of ocular findings in children with anemia

Evaluation of Ocular Findings by Optical Coherence Tomography in Children with Anemia. Medical Specialty Thesis, Van Yuzuncu Yil University, Institute of Health Sciences, Department of Pediatrics, Van. This study aimed to evaluate retinal structural changes using optical coherence tomography (OCT) in children aged 4–18 years with iron deficiency anemia (IDA), vitamin B12 deficiency anemia, and cases with combined deficiencies. The objective was to monitor anemia-related ocular findings dynamically by comparing these retinal changes with hematological and biochemical parameters before and after treatment. A total of 54 patients from Van Yüzüncü Yıl University Faculty of Medicine, Department of Pediatrics, and 26 healthy controls were included. Patients were divided into two groups: IDA (n=35) and vitamin B12 deficiency anemia and IDA (n=19). All participants underwent assessment of hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), serum iron, ferritin, and total iron-binding capacity (TIBC) prior to and one month after treatment. OCT measurements included retinal nerve fiber layer (RNFL) thickness, subfoveal choroidal thickness, and macular thickness. Before treatment, the IDA group had significantly lower Hb, Hct, MCV, ferritin, and serum iron levels, while TIBC was higher (p<0.001). All hematological parameters improved significantly after treatment (p<0.001). OCT analysis revealed significantly reduced global, superior, and temporal RNFL thicknesses and subfoveal choroidal thickness in anemic groups compared to controls (p<0.05, p<0.001). Following treatment, RNFL and subfoveal choroidal thicknesses increased significantly (p<0.05), while no significant change was vii observed in macular thickness (p>0.05). Pre-treatment RNFL and choroidal thicknesses showed positive correlations with hematological parameters, especially with Hb and ferritin levels. In conclusion, iron and vitamin B12 deficiencies in childhood lead to structural retinal changes in addition to hematological effects, which can be reliably monitored using OCT. The observed improvements in retinal parameters after treatment highlight the value of OCT for evaluating anemia-related ocular findings and monitoring treatment response. Routine ophthalmological screening may contribute to the protection of ocular health in anemic children. Keywords: Choroidal Thickness, Iron Deficiency Anemia, Optical Coherence Tomography, Retinal Nerve Fiber Layer, Vitamin B12 Deficiency Anemia.