Objective: To observe the characteristics of ocular biological parameters in children with transfusion-dependent β-thalassemia (TDT) and the effect of iron chelator treatment on them. Methods: This was a cross-sectional study. Thirty-two children with TDT (TDT group) and 64 healthy children (control group) who were treated in the Affiliated Hospital of Guangdong Medical University from October 2022 to June 2023 were included. There were 17 males and 15 females in the TDT group, with an age of (10.32±3.58) years; and 34 males and 30 females in the control group, with an age of (10.70±3.23) years. The children with TDT were divided into TDT1 group (using a single iron chelator) and TDT2 group (using two iron chelators in combination) according to the treatment situation of blood transfusion combined with iron chelator. The growth and development indicators such as height, weight and BMI of the children were recorded; the axial length (AL), anterior chamber depth (ACD), lens thickness (LT), central corneal thickness (CCT), corneal horizontal diameter (WTW), and the mean corneal curvature (Km) was calculated; the average size (AVG) of corneal endothelial cells and corneal endothelial cell density (CD) were measured using the corneal endothelium cytometer SP-3000P. to integer values; the blood transfusion time, serum ferritin before and after blood transfusion, the Results: The height, weight and BMI of the TDT group were all smaller than those of the control group (all P<0.001). The AL of the TDT group was (23.21±0.98) mm, shorter than that of the control group (24.01±1.16) mm; the ACD was (3.49±0.24) mm, shallower than that of the control group (3.63±0.25) mm; the LT was (3.52±0.18) mm, thicker than that of the control group (3.39±0.16) mm; The Km value (44.12±1.59) D is higher than that of the control group (42.93±1.34) D; the CD was (3 035.71±312.59) cells/mm², smaller than that of the control group (3 260.46±248.11) cells/mm² (all P<0.05). In the TDT group, AL and ACD were positively correlated with height (r=0.497,0.454;both P<0.05), and LT was negatively correlated with height (r=-0.400, P<0.05). The age of the TDT2 group was greater than that of the TDT1 group, the LT was smaller than that of the TDT1 group (P>0.05), and the CD was smaller than that of the TDT1 group (P<0.05). Conclusions: The growth and development of children with TDT are retarded, manifested as short axial length, shallow anterior chamber, thickened lens, higher mean corneal curvature and decreased corneal endothelial cell density. The use of iron chelators may cause corneal changes such as decreased corneal endothelial cell density.
目的： 观察输血依赖型β地中海贫血（TDT）儿童眼生物参数的特征，以及铁螯合剂治疗对其的影响。 方法： 横断面研究。纳入2022年10月至2023年6月在广东医科大学附属医院诊治的32例TDT患儿（TDT组）和64名健康儿童（对照组）。TDT组男性17例，女性15例，年龄（10.32±3.58）岁；对照组男性34名，女性30名，年龄（10.70±3.23）岁。根据TDT患儿输血联合铁螯合剂治疗情况分为TDT1组（单独使用1种铁螯合剂）和TDT2组（双联用药）。记录受检儿童身高、体重、体质量指数（BMI）等生长发育指标；使用光学生物测量仪LS-900收集眼轴长度、前房深度、晶状体厚度（LT）、中央角膜厚度（CCT）、角膜水平径（WTW）及角膜平均曲率（Km）；使用角膜内皮细胞计测量角膜内皮细胞平均大小（AVG）、角膜内皮细胞密度（CD）等。 结果： TDT组身高、体重和BMI均小于对照组（均P<0.001）。TDT组眼轴长度为（23.21±0.98）mm，短于对照组（24.01±1.16）mm；前房深度为（3.49± 0.24）mm，浅于对照组（3.63±0.25）mm；LT为（3.52±0.18）mm，厚于对照组（3.39±0.16）mm；Km为（44.12±1.59）D，高于对照组（42.93±1.34）D；CD为（3 035.71±312.59）个/mm²，小于对照组（3 260.46±248.11）个/mm²；AVG（333.45±37.26）μm2，大于对照组（308.28±22.79）μm2（均P<0.05）。TDT组中，眼轴长度、前房深度与身高呈正相关（r=0.497，0.454； 均P<0.05），LT与身高呈负相关（r=-0.400， P<0.05）。TDT2组年龄大于TDT1组，LT小于TDT1组（P>0.05），CD小于TDT1组（P<0.05）。 结论： TDT患儿生长发育迟缓，表现为眼轴短小、前房偏浅、晶状体增厚、角膜平均曲率增高以及角膜内皮细胞密度降低。铁螯合剂使用情况可能引起角膜内皮细胞密度降低等角膜改变。.