Khan Saad A, Naqvi Syed Ali H, Saeed Amber, Khan Wajid A, Moqeet Muhammad A, Ali Warda, Khan Faheem U
Cornea and Refractive Surgery, Al-Shifa Trust Eye Hospital, Rawalpindi, PAK.
Cureus. 2022 Dec 1;14(12):e32122. doi: 10.7759/cureus.32122. eCollection 2022 Dec.
Background Peripheral neuropathy is a controversial but serious complication of beta-thalassemia (β-Th). Although few studies have reported no relationship between neuropathy and thalassemia, many have linked it with increasing age, iron overload, and iron chelator toxicity. This study aims to investigate the presence of neuropathy in β-Th using corneal nerve fibers. Methodology A cross-sectional study was conducted using corneal confocal microscopy on individuals with intermediate and major β-Th who were compared to healthy individuals. The main outcome variables were corneal main nerve and branch nerve densities which were calculated using Image J software. The comparison between groups was done using the independent-samples F-test and Bonferroni post-hoc analysis. Results There was reduced corneal main nerve and branch nerve density in β-Th intermediate and major patients compared to the control group, and the results were statistically significant (p-value <0.05). However, a significant correlation was not observed between serum ferritin levels and corneal nerve parameters. Conclusions The reduction in corneal nerve parameters in β-Th patients compared to healthy controls can be an indication of peripheral neuropathy in β-Th. Further work is needed to confirm these findings.
背景 周围神经病变是β地中海贫血（β-Th）一种存在争议但严重的并发症。尽管很少有研究报告神经病变与地中海贫血之间没有关系，但许多研究已将其与年龄增长、铁过载和铁螯合剂毒性联系起来。本研究旨在利用角膜神经纤维调查β-Th患者中神经病变的存在情况。方法 采用角膜共焦显微镜对中间型和重型β-Th患者进行横断面研究，并与健康个体进行比较。主要结局变量是角膜主神经和分支神经密度，使用Image J软件进行计算。组间比较采用独立样本F检验和Bonferroni事后分析。结果 与对照组相比，β-Th中间型和重型患者的角膜主神经和分支神经密度降低，结果具有统计学意义（p值<0.05）。然而，未观察到血清铁蛋白水平与角膜神经参数之间存在显著相关性。结论 与健康对照相比，β-Th患者角膜神经参数降低可能表明β-Th存在周围神经病变。需要进一步开展工作以证实这些发现。
