Optical coherence tomography angiography findings in transfusion-dependent beta-thalassemia patients with and without splenectomy

Background: Ocular involvement is common in transfusion-dependent beta-thalassemia (TD beta-T) patients. We aimed to investigate the effect of splenectomy on optical coherence tomography angiography (OCTA) findings in TD beta-T patients. Methods: The study is a prospective cross-sectional study. A total of 45 eyes of 23 patients with splenectomy (34.04 +/- 8.83 years), 18 eyes of 9 patients without splenectomy (27.44 +/- 5.43 years), and 54 eyes of 27 controls (33.22 +/- 6.44 years) were included. Vessel density in superficial capillary plexus, deep capillary plexus and radial peripapillary capillary, foveal avascular zone, choriocapillaris flow area, choroidal and retinal thickness detected by OCTA were evaluated. p < 0.05 was considered significant.Results: Vessel density of superficial capillary plexus and deep capillary plexus were similar in patients with and without splenectomy, and controls. Choriocapillaris flow area was significantly decreased in patients with splenectomy than that in those without splenectomy and controls (2.02 +/- 0.12 vs. 2.17 +/- 0.1 and 2.14 +/- 0.12; p < 0.001). Choroidal thickness was significantly lower in patients without splenectomy than in patients with splenectomy and controls (260.05 +/- 61.02 vs. 305.11 +/- 42.13 and 298.89 +/- 29.14, p = 0.008). Parafoveal and perifoveal thickness of the full retina and outer retina were significantly lower in patients without splenectomy than in patients with splenectomy and controls (301.06 +/- 10.0, 279.78 +/- 10.28 vs. 311.04 +/- 14.89, 290.87 +/- 13.67 and 316.63 +/- 13.57, 289.56 +/- 9.31,p < 0.001 andp = 0.002; 174.72 +/- 7.81, 167.17 +/- 6.21 vs. 182.87 +/- 8.81, 173.60 +/- 7.09 and 185.11 +/- 9.26, 173.96 +/- 6.79, p = 0.001 and p < 0.001, respectively).Conclusions: OCTA findings can provide information about the microvascular effects of splenectomy on the retina of patients with TD beta-T.