Firdous Maryam, Umer Muhammad Farooq, Chandran Suriyakala Perumal
School of Nursing and Applied Science, Lincoln University College, Selangor 47301, Malaysia.
Department of Preventive Dental Sciences, College of Dentistry, King Faisal University, Hofuf 31982, Al-Ahsa, Saudi Arabia.
Int J Ophthalmol. 2025 Jun 18;18(6):1113-1122. doi: 10.18240/ijo.2025.06.19. eCollection 2025.
To describe the optical coherence tomography (OCT) findings of the retinal nerve fiber layer thickness (RNFLT) and choroidal thickness (CT) in beta-thalassemia major.
A systematic search was conducted on PubMed, Cochrane, and Embase using a combination of specific key words. The records found were screened in two phases (title/abstract, and full-text screening). All the original observational cross-sectional studies conducted on beta-thalassemia major cases and controls reporting the RNFLT and CT were included. The Meta-analysis was run for comparing the OCT measurements between beta-thalassemia cases and controls including pooled effect size, confidence intervals (CI), quality assessment, and publication bias. The measurements included were RNFLT (average, and in various quadrants), and CT.
A total of 10 studies were included in this Meta-analysis including a total of 684 individuals, 362 cases and 322 controls. The RNFLT and CT showed a significant reduction in the values of beta-thalassemia cases as compared to controls. The heterogeneity among the included studies was found to be 92.65% for the average RNFLT and 30.13% for the CT making it obvious to use random effects model for analyzing the RNFLT values while fixed effects model for the CT. The Egger's test showed significant publication bias among all the parameters except for nasal RNFLT (=0.507), and CT (=0.281). The estimated average effect size for the average RNFLT was 1.04 (95%CI: 0.35 to 1.72, =2.961, =0.003) and for CT was 0.74 (95%CI: 0.51 to 0.96, =6.523, <0.001).
This Meta-analysis concludes that the RNFLT and CT are significantly thinner in beta-thalassemia cases in comparison to healthy individuals. Therefore, the RNFLT and CT must be evaluated in routine clinical practice in order to avoid irreversible vision loss particularly in beta-thalassemia individuals.
描述重型β地中海贫血患者视网膜神经纤维层厚度（RNFLT）和脉络膜厚度（CT）的光学相干断层扫描（OCT）结果。
使用特定关键词组合在PubMed、Cochrane和Embase上进行系统检索。检索到的记录分两个阶段进行筛选（标题/摘要和全文筛选）。纳入所有对重型β地中海贫血病例和对照进行的原始观察性横断面研究，这些研究报告了RNFLT和CT。进行Meta分析以比较重型β地中海贫血病例和对照之间的OCT测量结果，包括合并效应量、置信区间（CI）、质量评估和发表偏倚。纳入的测量指标包括RNFLT（平均值及各个象限）和CT。
本Meta分析共纳入10项研究，共计684人，其中362例病例和322例对照。与对照组相比，重型β地中海贫血病例的RNFLT和CT值显著降低。纳入研究中，平均RNFLT的异质性为92.65%，CT的异质性为30.13%，这表明分析RNFLT值时明显应使用随机效应模型，而分析CT时应使用固定效应模型。Egger检验显示，除鼻侧RNFLT（=0.507）和CT（=0.281）外，所有参数均存在显著发表偏倚。平均RNFLT的估计平均效应量为1.04（95%CI：0.35至1.72，=2.961，=0.003），CT的估计平均效应量为0.74（95%CI：0.51至0.96，=6.523，<0.001）。
本Meta分析得出结论，与健康个体相比，重型β地中海贫血病例的RNFLT和CT明显更薄。因此，在常规临床实践中必须评估RNFLT和CT，以避免不可逆的视力丧失，尤其是在重型β地中海贫血患者中。
