Severe proliferative diabetic retinopathy associated with acromegaly

Inokuchi, Naoki; Ikeda, Tsunehiko; Yasuda, Fuyuko; Shirai, Setuko; Uchihori, Yasutaka

doi:10.1136/bjo.83.5.628c

Cited by 11 publications

(7 citation statements)

References 11 publications

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“…A number of case reports have reported increased severity of diabetic retinopathy in patients with acromegaly 2 14. However, data on the effects of GH and IGF-1 on retina are conflictual.…”

Section: Discussionmentioning

confidence: 99%

Corneal biomechanical properties of patients with acromegaly

et al. 2014

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“…A number of case reports have reported increased severity of diabetic retinopathy in patients with acromegaly 2 14. However, data on the effects of GH and IGF-1 on retina are conflictual.…”

Section: Discussionmentioning

confidence: 99%

Corneal biomechanical properties of patients with acromegaly

et al. 2014

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“…Thus, Dills et al (15) found an association between diabetic retinopathy and elevated serum IGF-I levels. Inokuchi et al (12) reported increased IGF-I levels in the vitreous of their acromegalic patient with diabetic retinopathy. Increased serum IGF-I levels were also reported with progressive diabetic retinopathy during pregnancy (16).…”

Section: Introductionmentioning

confidence: 97%

“…The relationship between pituitary growth hormone, diabetes and its vascular complications has recently been reviewed (7). It was observed that excessive GH secretion, such as in acromegaly induced diabetes and ketoacidosis (8 -10), and that in several instances acromegaly is accompanied by severe diabetic retinopathy (11)(12)(13). Treatment of acromegaly reduced the insulin requirement, improved the glucose intolerance (14) and induced regression of the retinopathy (13).…”

Section: Introductionmentioning

confidence: 99%

Diabetic retinopathy in two patients with congenital IGF-I deficiency (Laron syndrome)

Laron

Weinberger

2004

European Journal of Endocrinology

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Objective: Animal and clinical studies have shown that excessive amounts of growth hormone or insulin-like growth factor-I (IGF-I) promote the development of diabetes and diabetic retinopathy. Forthwith, we present two patients with congenital IGF-I deficiency who developed type II diabetes and subsequently retinopathy. Methods: Eighteen adult patients with classical Laron syndrome (8 males, 10 females, aged 20 -62 years) were followed by us since childhood or underwent fundus photography with a Nikon NF 505 instrument. Three had been treated in childhood with IGF-I, the rest were never treated, including the two patients reported. Results: Two never-treated patients were diagnosed with type II diabetes (DM) at ages 39 and 41 respectively. There was no diabetes in the families. Oral treatment was followed by insulin injections. Metabolic control was not optimal and one patient developed proliferative diabetic retinopathy, necessitating laser surgery. He also has nephropathy and severe neuropathy. The other patient has background diabetic retinopathy and has developed, progressively, exudates, microaneurisms, hemorrhages and clinically significant macular edema. He also has subacute ischemic heart disease. Conclusions: Our findings show that congenital IGF-I deficiency, similar to excess, causes vascular complications of DM, denoting also that vascular endothelial growth factor can induce neovascularization in the presence of congenital IGF-I deficiency.

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“…[141516] According to some authors, severe forms are rather due to a very long standing of diabetes disease, advanced age, eye refractive errors, or to genetic disorders as in primary diabetes mellitus. [12]…”

Section: Discussionmentioning

confidence: 99%

“…As we observed it, DR in acromegaly is described as slight or moderate,[ 12 ] but severe ones, although uncommon, are also reported in anecdotic cases. [ 14 15 16 ] According to some authors, severe forms are rather due to a very long standing of diabetes disease, advanced age, eye refractive errors, or to genetic disorders as in primary diabetes mellitus. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

Diabetic retinopathy in acromegaly

Azzoug

Chentli

2014

Indian J Endocr Metab

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Introduction:Although growth hormone (GH) has been implicated in the pathogenesis of diabetic retinopathy (DR), DR is deemed to be rare in patients with GH excess. Our aim was to study its prevalence in subjects with acromegaly suffering from diabetes mellitus (DM), to analyze its characteristics, and to look for predictive factors such as age at diagnosis, GH concentration and duration, DM duration, DM control, and family background.Materials and Methods:Forty patients with acromegaly and DM (21 males, 19 females), median age = 50 years, underwent a systematic ophthalmological examination with dilated funduscopy to seek diabetic retinopathy.Results:Among this population, 05 (12.5%) had DR. It was at an early stage or background retinopathy in 3 cases and at a more advanced stage or proliferative retinopathy in 2 cases. We did not find any correlation with age at diagnosis, GH levels and duration, DM duration and family history of DM, but poor glycemic control seems to play a role although statistical analysis showed borderline significance.Conclusion:From this study, we conclude that prevalence of DR in patients with acromegaly is 12.5%, and it is slight or moderate. Among studied factors, only poor glycemic control seems to be implicated in its development.

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Severe proliferative diabetic retinopathy associated with acromegaly

Cited by 11 publications

References 11 publications

Corneal biomechanical properties of patients with acromegaly

Corneal biomechanical properties of patients with acromegaly

Diabetic retinopathy in two patients with congenital IGF-I deficiency (Laron syndrome)

Diabetic retinopathy in acromegaly

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