Ocular Complications Among Patients with Beta-Thalassemia Major and Intermedia Patients: A Comparative Study from Pakistan

Beta-thalassemia is associated with systemic complications from chronic anemia, iron overload, and long-term transfusion therapy, which may also affect ocular structures. This study aimed to compare the frequency and patterns of ocular complications between patients with β-thalassemia major and β-thalassemia intermedia. This comparative cross-sectional study included 30 patients (60 eyes) with β-thalassemia major or β-thalassemia intermedia, recruited via convenience nonprobability sampling. All participants underwent comprehensive optometric and ophthalmic evaluation, including assessments of visual acuity, intraocular pressure, stereopsis, tear break-up time, visual field testing, and slit-lamp examination of the anterior and posterior segments. Serum ferritin levels were also recorded, and statistical analysis was performed using SPSS version 21. The mean age of participants was 20. 20.67 ± 7. 44 years, and 60% were female. Serum ferritin levels were significantly higher in patients with β-thalassemia major than in those with β-thalassemia intermedia (4056. 47 ± 2415. 28; p < 0. 001). Uncorrected visual acuity and superior visual field extent were significantly better in the intermedia group (0. 913 ± 0. 196 decimal and 52. 67 ± 7. 74 degrees, respectively; p < 0. 05). Tear break- up time was significantly longer in the major group (9. 87 ± 4. 25 seconds) than in the intermedia group (6. 27 ± 3. 91 seconds; p < 0. 005). Patients receiving chelation therapy for more than 5 years had significantly lower tear break-up time values (p = 0. 04). Lenticular abnormalities were observed in 10% of eyes in both groups, whereas vitreous condensations and peripheral fundus atrophic changes were more frequent in β-thalassemia intermedia. In conclusion, patients with β-thalassemia major have higher serum ferritin levels and poorer visual function, whereas certain posterior segment changes appear more prevalent in β-thalassemia intermedia. These findings highlight the importance of regular ophthalmic screening in patients with thalassemia.