The effect of parenteral iron treatment on ocular vascularity in female patients with iron deficiency anemia.

PURPOSE: To evaluate the effect of parenteral iron treatment on the choroidal thickness, retinal nerve fiber layer (RNFL) thickness and retrobulbar blood flow in females with iron deficiency anemia (IDA) and to explore the mediation role of the changes in Doppler flow parameters in this relationship.

METHODS

A total of 55 eyes of 55 females in the reproductive period with a diagnosis of IDA were included in this prospective observational study. The hematologic values and the choroidal thickness at the subfoveal area and 500, 1000, 1500 µm nasal and temporal to the fovea, RNFL thickness, and central retinal artery (CRA) and ophthalmic artery (OA) parameters one day before and 8-12 weeks after parenteral iron treatment were evaluated in the patients.

RESULTS

The choroidal thickness at all measurement points and the RNFL thickness in all quadrants were significantly higher than the pre-treatment values following treatment (p < 0.05). The CRA peak systolic velocity (PSV) and end-diastolic velocity (EDV) values and the OA PSV values were statistically significantly lower after treatment compared to the pre-treatment values (p < 0.001, p < 0.01, p = 0.05, respectively). According to the mediation analysis, changes in hemoglobin (Hb), hematocrit (Hct), and mean corpuscular volume indirectly affected the superior RNFL thickness via the changes observed in OA EDV and the pulsatile index.

CONCLUSIONS

Parenteral iron treatment leads to significant improvement in both the hematological parameters and the retinal and choroidal circulation. This improvement was found to occur in a balanced manner through the changes in the retrobulbar blood flow parameters.