Decreased Retinal Nerve Fiber Layer Thickness in Patients with Congenital Isolated Growth Hormone Deficiency

Nalcacioglu-Yuksekkaya, Pınar; Şen, Emine; Yilmaz, Sebahat; Elgin, Ufuk; Günaydın, Süleyman; Aycan, Zehra

doi:10.5301/ejo.5000481

Cited by 7 publications

(7 citation statements)

References 29 publications

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“…Consequently, most of the previous studies relevant with IGHD were focused on the retina. 4,8,24 Normal macular thickness and decreased retinal fiber layer thickness were found to be associated with IGHD according to these studies.…”

Section: Discussionmentioning

confidence: 56%

“…19 In studies that show relationship between GH and cornea, GH was said to have an effect on postnatal growth of the eye via IGF-I production. 7,20,21 GH was found in the vitreous of rat eyes in immunochemical studies. 22,23 In addition, GH and GH receptors have been shown in retinal ganglion cells.…”

Section: Discussionmentioning

confidence: 96%

“…3 Many different ocular abnormalities have been reported in patients with GH deficiency. [4][5][6][7][8] GH has been shown to have angiogenic effects and retinal cells are known as a domain of local growth factors, including insulin-like growth factor-I (IGF-I). 9 Reduced retinal vascularization in Laron syndrome (GH insensitivity syndrome) demonstrated that GH-IGF-I axis is crucial for normal vascularization of the human retina.…”

Section: Introductionmentioning

confidence: 99%

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Choroidal thickness measurements in children with isolated growth hormone deficiency

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et al. 2017

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PurposeThe aim of this study was to determine the choroidal thickness measurement values in cases with isolated growth hormone deficiency (IGHD), to compare them with the healthy control group by using enhanced depth imaging optical coherence tomography (EDI-OCT), and to evaluate the effect of growth hormone (GH) treatment on choroid.Patients and methodsIn this study, 23 cases who were diagnosed with IGHD as a study group and 46 healthy subjects as a control group were included. All patients and controls underwent a complete ophthalmologic examination, including an examination with EDI-OCT. Choroidal thickness (CT) was measured at the fovea and at 1000 μm intervals from the foveal center in both temporal and nasal directions.ResultsThe mean subfoveal choroidal thickness (SFCT) was 329.04±88.49 μm in the cases with IGHD and 365.35±50.48 μm in the control group (P=0.033). The mean CT at temporal 1 and 2 mm were thinner in the IGHD group than that of control group (P=0.033 and P=0.043, respectively). Nasal quadrant measurements were also found to be thinner in the IGHD cases than that of control group, but the difference was not statistically significant. We found a significant positive correlation between pubertal staging and SFCT (r=0.607, P=0.006). There was no statistically significant difference in CT values of the study group between before and 12 months after GH treatment (P>0.05).ConclusionThis study shows patients with IGHD has a thinner CT when compared with healthy pediatric cases. GH treatment seems to be not associated with the choroidal development.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Choroidal thickness measurements in children with isolated growth hormone deficiency

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et al. 2017

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“…In view of this knowledge, we expected that the GHD would have led to greater thinning of the MT and RNFL thickness, but our findings did not support this expectation. Decreased peripapillary nerve fiber thickness and decreased optic disc size were previously described in some children with congenital GHD ( 17 , 18 ). The differences between these reports and our findings are probably due to the variety of causes of GHD as well as to differences in methodology.…”

Section: Discussionmentioning

confidence: 68%

Retinal Neural and Vascular Structure in Isolated Growth Hormone Deficiency Children and Evaluation of Growth Hormone Treatment Effect

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et al. 2018

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Objective:To evaluate neural and vascular retinal morphology of children with isolated growth hormone deficiency (GHD) and to determine any retinal changes due to GH treatment.Methods:Twenty-eight children with isolated GHD and 53 age-, gender- and body mass index-matched healthy volunteers were enrolled in this prospective study. The retinal nerve fibre layer (RNFL) and macular thickness (MT) were measured, as well as intraocular pressure (IOP). The number of retinal vascular branching points were calculated. Effect of GH treatment on the retina and IOP was evaluated after one year of treatment. Measurements were also made in the control group at baseline and following the initial examination. Pre- and post-treatment changes were compared. The findings were also compared with those of the controls. The correlation between ocular dimensions and insulin-like growth factor-I (IGF-1) levels were also analysed.Results: The number of branching points was significantly lower in GHD patients as compared with control subjects (15.11±2.67 and 19.70±3.37, respectively, p=0.05 for all comparisons). No statistically significant differences were found in mean RNFL, MT and IOP values between GHD patients and control subjects. GH treatment did not create any significant changes in the retinal vascularization or other retinal neural parameters and IOP either within the patient group or when compared with the control group. No correlations were observed between ocular dimensions and IGF-1 levels.Conclusion:Our findings suggest that isolated GHD may lead to decreased retinal vascularization. However, retinal neural growth and differentiation were not affected by GHD. These findings may be related to the fetal development process of pituitary somatotropic cells and the retina. Additionally, GH treatment did not cause any changes in retinal neural and vascular tissues.

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“…Another novel finding of the present study is the normal nerve fiber layer thickness in these subjects, coinciding with the normality of the macular thickness. Nerve fiber layer thickness was reported as thinner in congenital (not proven genetically) treated GHD children [ 34 ], in children with acquired GH deficiency [ 35 ], and in adult women with Sheehan syndrome, a model of acquired hypopituitarism with GH deficiency [ 36 ]. GH-producing cells can be identified in the retina at nine weeks of gestation, while embryonic neural development occurs at an earlier period [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Quantitative measures of the vascular and neural components of the retina in adult individuals with congenital and untreated growth hormone deficiency

et al. 2022

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Background The somatotrophic axis, including hypothalamic growth hormone (GH)-releasing hormone (GHRH), pituitary GH and circulating IGF-I, is critical for body size. However, the local production of GH/IGF-I (and IGF-II) and other peptides is relevant for other body functions, such as vascular, brain, and retinal function. The consequences of GH deficiency (GHD) on the retinal structure are still unclear, possibly reflecting the heterogeneity of patients and the different types of assessment in previous publications. Our purpose was to assess quantitative measures of the vascular and neural components of the retina in subjects with severe congenital isolated GHD (IGHD). Methods A cross-sectional study was carried out in 25 adult IGHD subjects and 25 age- and gender-matched controls. Interview, physical examination, laboratory data, optical coherence tomography (OCT) and OCT angiography (OCTA) were performed. Results OCT revealed no difference in the areas of the nerve fiber layer average, nor in the areas of superior, inferior, or nasal quadrants, between the two groups. However, areas of the temporal quadrant (p = 0.041), the optical disc (p = 0.042), the cup (p < 0.0001), as well as the cup/disc ratio (p < 0.0001), were higher in IGHD subjects than controls. The rim area was smaller (p = 0.002), although still normal. In OCTA, there was no difference in the minimum foveal thickness, central fovea, foveal avascular zone, and retinal density in any assessed area. Conclusions In conclusion, congenital IGHD does not affect quantitative measures of the vascular and neural retina, and it is associated with increased optical disc in this genetically homogeneous cohort.

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Decreased Retinal Nerve Fiber Layer Thickness in Patients with Congenital Isolated Growth Hormone Deficiency

Abstract: The results suggest that congenital GHD may lead to thinner RNFL thickness when compared with healthy subjects. This indicates that GH has an important role in the development of the neural retina.

Cited by 7 publications

References 29 publications

Choroidal thickness measurements in children with isolated growth hormone deficiency

Choroidal thickness measurements in children with isolated growth hormone deficiency

Retinal Neural and Vascular Structure in Isolated Growth Hormone Deficiency Children and Evaluation of Growth Hormone Treatment Effect

Quantitative measures of the vascular and neural components of the retina in adult individuals with congenital and untreated growth hormone deficiency

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