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Year : 2015  |  Volume : 108  |  Issue : 4  |  Page : 167-172

Evaluation of large cupping in children with anemia

1 Department of Ophthalmology, Beni Suef University, Beni Suef, Egypt
2 Department of Ophthalmology, Fayoum University, Fayoum, Egypt
3 Department of Ophthalmology, Misr University for Science and Technology, October, Egypt
4 Department of Ophthalmology, Research Institute of Ophthalmology, Giza, Egypt
5 Department of Pediatric, National Institute for Laser Enhanced Sciences, Giza, Egypt
6 Department of Medicine, Beni Suef University, Beni Suef, Egypt

Correspondence Address:
Mohamed Yasser S Saif
Department of Ophthalmology, Faculty of Medicine, Beni Suef University, 5 Sherif St, Babel Louk Sq, Cairo 11111
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2090-0686.174651

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Introduction In adults, large optic disc cups are often a sign of glaucoma. Children, however, show a lower prevalence of glaucoma than adults, but may present with optic disc cupping of nonglaucomatous origin. Aim of the work The purpose of this study is to evaluate with large cupping in children having anemia. Patients and methods This is a prospective analysis of patients attending the ophthalmology outpatient clinic in Beni Suef, Fayoum, and Misr universities. All patients were subjected to standard ophthalmological examination, optical coherence tomography (OCT), fundus photography, complete blood count (CBC), and stool analysis to diagnose the cause of anemia. Results In this study examination cupping of greater than 0.4 was detected in 236 patients out of 3361 patients examined within the same age. The mean age of the selected patients (236 patients) was 11.48 ± 3.2 ranging from 6 to 18 years of which 137 (58.05%) were girls and 99 (41.95%) boys. The mean best corrected visual acuity converted to logMAR is 0.093 ± 0.109 ranging from 0.301 (6/12) in 53 eyes to 0 (6/6) in 260, whereas the rest best-corrected visual acuity 0.176 (6/9). The mean intraocular pressure was 11.75 ± 1.539.The mean cup disc ratio was 0.498 ± 0.0934 (0.497 ± 0.095 for females and 0.501 ± 0.090 for males). The majority of patients (females more than males) had C/D ratio similarity between both eyes, whereas very few had 0.2 differences (males more than females). The mean Hb concentration was 10.79 ± 0.89 g/dl in females and 11.04 ± 1.09 g/dl in males. It was as low as 7.2 in males and 7.8 in females. The stool analysis for the patients showed that 126 patients (74 females, 52 males) were infected with Entamoeba histolytica, whereas 31 patients (22 females, nine males) were infected with Giardia lamblia and 79 patients did not have parasitic manifestations. Conclusion In conclusion to our work we found that functional optic nerve damage is a possibility in children with anemia and cupping and with normal intraocular pressure and that there is very high incidence of parasitic infestation in those children and young adolescents that warns for state intervention to deal with this problem. A larger scanning by the ministry of health may be needed to verify these results.

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