Retinal abnormalities in children suffering from low hemoglobin levels

Background: Anemia is a major public health problem with total prevalence of 30%. It is one of the hematological disorders which can induce retinal changes that are due to retinal hypoxia that leads to nerve fiber layer infarction. Other change includes increased vascular permeability, venous stasis, angiospasm and increased blood viscosity.Methods:  This is the cross-sectional study that includes 230 children with age group of 1 to15 years having hemoglobin levels less than 10 gm/dl referred to eye OPD. Ocular examination was done which included-visual acuity, anterior segment, dilated fundus examination.Results: Retinopathy was observed in 95% children of severe anemia and 84% children of moderate anemia. Common findings observed vascular changes, dot blot hemorrhages, flame shaped hemorrhages, sub hyaloids hemorrhages, disc pallor and macular edema.Conclusions: Retinopathy is a frequent finding seen in moderate to severe anemic patients, as the retinal changes were found significantly in maximum patients, it is recommended that all anemic patients particular Hb less than 10 g/dl must undergo routine fundus examinations.

Correlative study of diabetic retinopathy in type 2 diabetes mellitus with haemoglobin A1c, duration of diabetes and modifiable risk factors: smoking, alcohol and BMI in adult population attending a tertiary care hospital

Background: Diabetes is a disease, which if not controlled, affects every cell of the body from head to toe. No wonder it is often referred to as the “SILENT KILLER”. So through our study, we aim to study the correlation between (haemoglobin A1c) HbA1c levels, duration of diabetes and modifiable risk factors with diabetic retinopathy (DR) in patients of type 2 diabetes mellitus.Methods: This study was conducted in 100 patients (200 eyes) who were diagnosed cases of type 2 diabetes mellitus. A detailed history of the duration of diabetes, alcohol intake and smoking and HbA1c levels was taken. Complete ocular examination was done. BMI was also calculated.Results: 2/3rd of the eyes with grade 3 DR were of>10 years duration while 2/3rd of the eyes with grade 2 DR were of 5-10 years duration. Of the eyes with grade 3 DR, all the patients had HbA1c of more than 8. Significant p value shows strong correlation between DR and obesity. No significant correlation of DR was found with alcohol and smoking.Conclusions: The findings in our study endorse the view that duration and HbA1c are important risk factors for occurrence and severity of DR and therefore a regular follow up and good glycemic control is highly essential for the prevention of occurrence and progression of DR. Strong correlation between BMI and DR suggest that lifestyle changes play a pivotal role