Venkatesh Ramesh, Gurram Reddy Nikitha, Jayadev Chaitra, Chhablani Jay
Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India.
Department of Retina and Vitreous, University of Pittsburg Faculty of Medicine, Pittsburg, USA.
Beyoglu Eye J. 2023 May 1;8(2):97-103. doi: 10.14744/bej.2023.05658. eCollection 2023.
To study the prevalence of fundus lesions in anaemics and define the hematological risk factors for retinopathy using the receiver operating characteristic curve analysis.
For this retrospective study, patients ≥18 years and diagnosed with anemia with dilated fundus examination by a retina specialist from May 2019-April 2020 were included. Anemic retinopathy (AR) was present if hemorrhages in different layers of the retina, Roth's spots, exudates, cotton wool spots, retinal edema, and optic disc changes were noted. Patients with secondary anemia were excluded. Two groups were identified: Group 1: Patients with AR; Group 2: Patients with no AR with normal fundus. Demographic features, fundus findings, and hematological parameters were noted.
38 (30%) eyes of 23 patients had AR; 90 (70%) eyes of 47 patients had no AR. The mean age in Group 1 and Group 2 was 54.7±18.9 and 58.6±15.3 years, respectively. Low hemoglobin (Hb) [mean = 7.82±1.64 gm/dl, p=<0.001] and hematocrit [mean = 26.93±5.22 %, p=0.002] values were noted in the AR group. AUC values for Hb (0.737) and hematocrit (0.719) were higher for the AR group. Hb < 8.95g/dl could predict AR with 85.8% sensitivity and 68.9% specificity, and hematocrit < 30.5% could predict AR with 80% sensitivity and 53.2% specificity. On regression analysis, Hb (p<0.001) and hematocrit (p=0.000) were associated with AR.
Retinopathy is frequently seen in severe anemic patients. It is recommended that patients having low anemia should undergo a retinal examination.
研究贫血患者眼底病变的患病率，并通过受试者工作特征曲线分析确定视网膜病变的血液学危险因素。
本回顾性研究纳入了2019年5月至2020年4月期间年龄≥18岁、经视网膜专科医生散瞳眼底检查确诊为贫血的患者。如果在视网膜不同层出现出血、Roth斑、渗出物、棉絮斑、视网膜水肿和视盘改变，则存在贫血性视网膜病变（AR）。排除继发性贫血患者。确定了两组：第1组：患有AR的患者；第2组：眼底正常且无AR的患者。记录人口统计学特征、眼底检查结果和血液学参数。
23例患者的38只眼（30%）患有AR；47例患者的90只眼（70%）无AR。第1组和第2组的平均年龄分别为54.7±18.9岁和58.6±15.3岁。AR组的血红蛋白（Hb）[平均值=7.82±1.64 g/dl，p<0.001]和血细胞比容[平均值=26.93±5.22%，p=0.002]值较低。AR组Hb（0.737）和血细胞比容（0.719）的AUC值较高。Hb<8.95g/dl预测AR的灵敏度为85.8%，特异度为68.9%，血细胞比容<30.5%预测AR的灵敏度为80%，特异度为53.2%。回归分析显示，Hb（p<0.001）和血细胞比容（p=0.000）与AR相关。
视网膜病变在重度贫血患者中常见。建议轻度贫血患者进行视网膜检查。
