Analysis of retinal nerve fibre layer thickness and optic disc parameters in patients of iron deficiency anaemia

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Swati Samant
Suchismita Mishra
Smaraki Mohanty
Deergha Pareek
Srikant Kumar Dhar
Pradeep Kumar Panigrahi


Background: To evaluate peripapillary retinal nerve fibre layer (RNFL) thickness and optic disc parameters in iron deficiency anaemia (IDA) patients and its correlation with various blood parameters of age and sex matched healthy controls with the help of spectral domain optical coherence tomography (SD-OCT).

Materials and methods: Cross sectional, hospital based study was done on patients with IDA and healthy patients attending departments of Ophthalmology and haematology of a tertiary referral hospital in Eastern India from June 2020 to January 2021. Comprehensive ophthalmic examination was done in all patients. Peripapillary RNFL thickness was measured using SD-OCT. Blood analysis for all patients included blood haemoglobin, serum iron binding capacity, Serum Ferritin, total iron binding capacity (TIBC), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin Concentration (MCHC).

Results: Twenty five patients with IDA and 25 age and sex matched healthy patients constituted the study and control groups respectively. Mean age of study and control groups was 40.44±5.51 and 39.12±11.60 years respectively. Strong positive correlation was noted between mean RNFL thickness and haemoglobin, serum ferritin, serum iron and serum transferrin levels. Negative correlation was noted between mean RNFL thickness and total iron binding capacity.

Conclusion: Patients with IDA in Eastern India have decreased mean peripapillary RNFL thickness. Mean RNFL thickness in different quadrants may not only be dependent on iron parameters but might also be influenced by dietary and geographical factors.


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Samant, S. ., Mishra, S., Mohanty, S., Pareek, D., Dhar, S. K., & Panigrahi, P. K. (2022). Analysis of retinal nerve fibre layer thickness and optic disc parameters in patients of iron deficiency anaemia. Journal of Associated Medical Sciences, 55(3), 1–6. Retrieved from
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Fairbanks VF. Iron-deficiency anemia. In: Mazza JJ, editor. Manual of Clinical Hematology. Philadelphia, USA: Lippincott Williams & Wilkins; 2002. pp. 17–38.

Soha Moussa Mohamed Eltohamy. Iron Deficiency Anemia as a risk factor for thining of peripapillary retinal nerve fibre layer thickness. International Journal of Advanced Research 2016; 4: 1067-1071.

Jaiswal SJ, Banait S, Daigavane SV. A comparative study on peripapillary retinal nerve fiber layer thickness in patients with iron-deficiency anemia to normal population. J Datta Meghe Inst Med Sci Univ 2018; 13: 9-11.

Relationship of iron to oligodendrocytes and myelination.Connor JR, Menzies SLGlia. 1996 ; 17: 83-93.

Kergoat H, Hérard ME, Lemay M. RGC sensitivity to mild systemic hypoxia. Invest Ophthalmol Vis Sci. 2006; 47: 5423–7.

Lozoff B. Early iron deficiency has brain and behavior effects consistent with dopaminergic dysfunction. J Nutr. 2011 Apr 1; 141(4): 740S-746S. doi: 10.3945/jn.110.131169.

Djamgoz MB, Hankins MW, Hirano J, Archer SN. Neurobiology of retinal dopamine in relation to degenerative states of the tissue. Vision Res. 1997; 37: 3509–29.

Cikmazkara I, Ugurlu SK. Peripapillary retinal nerve fiber layer thickness in patients with iron deficiency anemia. Indian J Ophthalmol. 2016; 64: 201-5.

Lonneville YH, Ozdek SC, Onol M, Yetkin I, Gürelik G, Hasanreisoglu B. The effect of blood glucose regulation on retinal nerve fiber layer thickness in diabetic patients. Ophthalmologica. 2003; 217: 347–50.

Ozdek S, Lonneville YH, Onol M, Yetkin I, Hasanreisoglu BB. Assessment of nerve fiber layer in diabetic patients with scanning laser polarimetry. Eye (Lond) 2002; 16: 761–5.

Huang, D, Swanson, EA, Lin, CP. Optical coherence tomography. Science 1991; 254: 1178–1181.

Nassif, N, Cense, B, Park, B. In vivo high-resolution video-rate spectral-domain optical coherence tomography of the human retina and optic nerve. Opt Express 2004; 12: 367–376.

Turkyilmaz K, Oner V, Ozkasap S, Sekeryapan B, Dereci S, Durmus M. Peripapillary Retinal Nerve Fibre Layer Thickness in children with Iron Deficiency Anemia. Eur J Ophthalmol 2013; 23: 217-22.

Lim MC, Tanimoto SA, Furlani BA, Lum B, Pinto LM, Eliason D, et al. Effect of diabetic retinopathy and panretinal photocoagulation on retinal nerve fiber layer and optic nerve appearance. Arch Ophthalmol 2009; 127: 857- 62.

F. Uzun, E. E. Karaca, G. Yıldız Yerlikaya et al., “Retinal nerve fiber layer thickness in children with β- thalassemia majorSaudi.” Saudi Journal of Ophthalmology 2017; 31: 224-8.

E. Akdogan, K. Turkyilmaz, T. Ayaz, and D. Tufekci, “Peripapillary retinal nerve fibre layer thickness in women with iron deficiency anaemia,” Journal of International Medical Research. 2015; 43: 104-9.

Dilek I, Erkocç R, Sayarlioglu M, Ilhan M, Alici S, Turkdogan K, et al. Hematological Values And Ferritin Levels of Healthy Adult Individuals In Van City Center and Countryside. Van Medical Journal. 2002; 9: 52–5.

Yılmaz FZ, Erdal S, Bakıcı Z, Cçınar Z. Investigation of the normal values of some haematological parameters of the adults living in the central region of Sivas. Erciyes Medical Journal. 2003; 25: 1–10.

Gandhi M, Dubey S. Evaluation of the Optic Nerve Head in Glaucoma. J Curr Glaucoma Pract. 2013; 7: 106-114.

Baniasadi N, Paschalis EI, Haghzadeh M, Ojha P, Elze T, Mahd M, Chen TC. Patterns of Retinal Nerve Fiber Layer Loss in Different Subtypes of Open Angle Glaucoma Using Spectral Domain Optical Coherence Tomography. J Glaucoma. 2016 ; 25: 865-872.

Tsutsumi T, Tomidokoro A, Saito H, Hashizume A, Iwase A, Araie M. Confocal Scanning Laser Ophthalmoscopy in HighMyopic Eyes in a Population-Based Setting. InvesOphthalmol Vis Sci. 2009; 50: 5281-5287.

Kamath AR, Lakshey D. Peripapillary retinal nerve fibre layer thickness profile in subjects with myopia measured using optical coherence tomography. J Clinical Ophthalmol Research. 2014; 2: 131-13.