Ophthalmologic and Audiologic Problems In Beta Thalassemia Patients Treated With Prolonged Chelation therapy
Roya Dolatkhah MD, Hematogy and Oncology Research Center - Tabriz University of Medical Sciences,Thalassemia and Hemophilia Center, Shahid Ghazi Tabatabai Hospital, Daneshghah Street, Tabriz,Iran
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Background: The main aim of chelation therapy in iron overload is to achieve an iron balance and to prevent haemosiderosis. The objective of this study was to Determine visual and hearing problems in adults with beta major and Intermediate Thalassemia who received Desferrioxamine (DFO) as chelation.
Patients and Methods: Fifteen patients aged 16 to 63 years, who received DFO by intravenous and subcutaneous route on regular program, were evaluated for 5 years. Variables such as age, sex, serum ferritin, DFO dose and duration of treatment gathered by a researcher designed questionnaire. Patients were examined by ophthalmologist and otolaryngologist. Data was collected using specific questionnaire and analyzed by SPSS 11 software.
Results: The mean serum ferritin level was 2025ng/ml and the mean treatment dose of DFO was 45mg/kg/day, 4 or 5 times a week. VEP (Visual Evoked Potential) and ERG (Electro Retino Graphy) ophthalmologic tests were negative in all of the patients. Two patients (13.3%) presented with cataract, and 2 others (13.3%) showed moderate visual loss. A mild, bilateral, high-frequency hearing loss developed in one patient. There was no significant relation between the serum ferritin levels and these problems.
Conclusion: These findings show any significant statistical relation between visual andaudiologic abnormalities and the use of high dose DFO or lower serum ferritin levels in our cases, yet regular ophthalmologic and audiologic examinations are advised for all thalassemic patients.