Women With Anemia Have Reduced Retinal Vasculature Parameters

Eye examination. Ophthamologist using an optical coherence tomograph (OCT) to measure the thickness of a patient’s retina. This machine images the retina in cross-section. The retina is the light sensitive membrane at the back of the eyeball. Both increases and decreases in retinal thickness can be symptoms of disease, although thickness does decrease with age.
Clinicians should be aware of retinal vascular alterations when treating patients with IDA and monitor ocular health appropriately.

Women with iron deficiency anemia (IDA) may have a narrower central retinal artery equivalent (CRAE) and lower arteriole-to-venule ratio (AVR) than healthy women, according to findings published in Photodiagnosis and Photodynamic Therapy.

Researchers enrolled women with IDA (n=28) and age-matched healthy controls (n=28) in a study and performed a detailed ophthalmic examination on all participants including anterior segment analysis, dilated fundus imaging, and intraocular pressure (IOP) measurement.

Participant serum hemoglobin levels were 8.48±1.11 and 12.38±1.71 g/dL, iron levels were 18.90±7.87 and 93.10±31.40 μg/dL, transferrin saturation was 4.25±1.83 and 35.80±12.40%, and ferritin levels were 3.50±2.18 and 117.60±51.82 μg/dL (P <.001 for all) among the IDA and control groups, respectively.

Researchers noted that patients with IDA had a significantly narrower CRAE and lower AVR compared with healthy controls. (185.2±20.6 vs 202.1±18.6 μm and .789±0.08 vs .870±0.09, respectively, P <.001 for both). However, they observed no significant differences with respect to the central retinal vein equivalent between the groups ( 236.7±33.1 vs 231.9±25.3 μm; P =.054).

Investigators also found that serum hemoglobin levels were associated with CRAE (R2=0.323; P =.005) and central retinal vein equivalent (R2=0.374; P =.002) among the IDA cohort. They observed no such association between hemoglobin and arteriole-to-venule ratio (R2, 0.041; P =.626).

For the controls, no associations between hemoglobin and CRAE, central retinal vein equivalent, or arteriole-to-venule ratio were observed (R2 range= −0.059−0.061; all >.05).

Researchers stress the importance of monitoring ocular health in women with IDA and state, “it may be critical to identify all alterations in retinal vascular caliber in order to prevent potential ocular and systemic disorders in patients with IDA.”

This study was limited by a small sample size, the exclusion of men, and failure to collect data regarding the duration of anemia.


Calli U, Coban F, Evliyaoglu F, Sönmez A. Retinal vascular caliber in patients with newly diagnosed iron deficiency anemia. Photodiagnosis Photodyn Ther. 2022;38:102751. doi:10.1016/j.pdpdt.2022.102751