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Klin Monbl Augenheilkd 2023; 240(08): 997-1003
DOI: 10.1055/a-2040-4144
Klinische Studie

The Effects of Long-term Growth Hormone Treatment on Ocular Findings

Die Auswirkungen einer Langzeitbehandlung mit Wachstumshormonen auf die Augenbefunde
Mehmet Tahir Eski
1   Ophthalmology, Private Erzincan Neon Hospital, Erzincan, Turkey
,
Kuddusi Teberik
2   Ophthalmology, Duzce University Medical School, Duzce, Turkey
,
Semih Bolu
3   Pediatric Endocrinology, Adiyaman Universitesi, Adiyaman, Turkey
,
Handan Ankarali
4   Biostatistics and Medical Informatics Department, Istanbul Medeniyet University, Istanbul, Turkey
,
Murat Kaya
2   Ophthalmology, Duzce University Medical School, Duzce, Turkey
,
Ilknur Arslanoglu
5   Pediatric Endocrinology, Duzce University Medical School, Duzce, Turkey
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Abstract

Purpose This study aimed to examine the long-term changes in anterior chamber depth (ACD), central corneal thickness (CCT), axial length (AxL), peripapillary retinal nerve fibre layer thickness (RNFLT), peripapillary ganglion cell layer – inner plexiform layer (GCL-IPL) thickness, and peripapillary choroidal thickness (ChT) after rhGH replacement treatment in paediatric patients with IGHD, compared to healthy controls.

Methods Twenty-two children with IGHD including 12 girls and 10 boys were enrolled in the study group, and 30 (16 girls, 14 boys) healthy children composed the control group. A detailed ophthalmological examination was performed for each participant. ACD, CCT, AxL, peripapillary RNFLT, GCL-IPL thickness and ChT measurements were performed before the rhGH replacement treatment and in the 12th month of the post-treatment period, as well as the corresponding visits in the control group. AxL ultrasound pachymetry (CCT), peripapillary RNFL thickness, peripapillary RNFLT, GCL-IPL thickness, and peripapillary ChT parameters were measured by spectral-domain optical coherence tomography.

Results The mean age of the groups were similar (p = 0.143). 12-month CCT, ACD, and AxL measurements of the study group showed significantly higher results than the pre-treatment measurements (p = 0.005, p = 0.024, and p = 0.002, respectively). Similarly, the mean RNFLT and ChT measurements of the study group obtained from all sectors were significantly higher in the 12th-month visit (p < 0.001 for both) other than the RNFLT, and GCL-IPL thickness measurements (p > 0.05 for all). However, all these parameters were similar at pre- and post-treatment visits in the control group (p > 0.05 for all). The mean pre-treatment values of all these parameters were significantly lower in the study group compared to the control group (p < 0.05 for all), other than the RNFLT, GCL-IPL thickness measurements (p > 0.05 for all), while the mean post-treatment values of all these parameters in both groups were similar at month 12 (p > 0.05 for all).

Conclusion GH replacement treatment in childhood may play an important role in the development of the neural retina and can be effective on the anterior segment, RNFLT and ChT measurements.

Zusammenfassung

Zweck Diese Studie zielte darauf ab, die langfristigen Veränderungen der Vorderkammertiefe (ACD), der zentralen Hornhautdicke (CCT), der axialen Länge (AxL), der Dicke der peripapillären retinalen Nervenfaserschicht (RNFLT), die Schichtdicke der peripapillären Ganglienzellschicht zusammen mit der inneren plexiformen Schicht (GCL-IPL) und die peripapilläre Aderhautdicke (ChT) nach rhGH-Ersatzbehandlung bei pädiatrischen Patienten mit IGHD im Vergleich zu gesunden Kontrollpersonen zu untersuchen.

Methoden 22 Kinder mit IGHD (isoliertem Wachstumshormonmangel), darunter 12 Mädchen und 10 Jungen, wurden in die Studiengruppe aufgenommen, und 30 (16 Mädchen, 14 Jungen) gesunde Kinder bildeten die Kontrollgruppe. Bei jedem Teilnehmer wurde eine ausführliche augenärztliche Untersuchung durchgeführt. ACD-, CCT-, AxL-, peripapilläre RNFLT-, GCL-IPL-Dicken- und ChT-Messungen wurden vor der rhGH-Ersatzbehandlung (rhGH: rekombinantes Wachstumshormon) und im 12. Monat der Nachbehandlung sowie bei den entsprechenden Besuchen in der Kontrollgruppe durchgeführt. AxL-Ultraschallpachymetrie (CCT), peripapilläre RNFL-Dicke, peripapilläre RNFLT, GCL-IPL-Dicke und peripapilläre ChT-Parameter wurden durch optische Kohärenztomografie im Spektralbereich gemessen.

Ergebnisse Das Durchschnittsalter der Gruppen war ähnlich (p = 0,143). 12-monatige CCT-, ACD- und AxL-Messungen der Studiengruppe zeigten signifikant höhere Ergebnisse als die Messungen vor der Behandlung (p = 0,005, p = 0,024 bzw. p = 0,002). In ähnlicher Weise waren die mittleren RNFLT- und ChT-Messungen der Studiengruppe aus allen Sektoren beim Besuch im 12. Monat (p < 0,001 für beide) signifikant höher als die RNFLT-, GCL-IPL-Dickenmessungen (p > 0,05 für alle). Alle diese Parameter waren jedoch bei den Besuchen vor und nach der Behandlung in der Kontrollgruppe ähnlich (p > 0,05 für alle). Die mittleren Vorbehandlungswerte all dieser Parameter waren signifikant niedriger in der Studiengruppe im Vergleich zur Kontrollgruppe (p < 0,05 für alle), mit Ausnahme der RNFLT-, GCL-IPL-Dickenmessungen (p > 0,05 für alle), während die Mittelwerte der Nachbehandlungswerte all dieser Parameter in beiden Gruppen in Monat 12 ähnlich waren (p > 0,05 für alle).

Schlussfolgerung Die rhGH-Ersatzbehandlung im Kindesalter kann eine wichtige Rolle bei der Entwicklung der neuralen Netzhaut spielen und kann bei Messungen des vorderen Segments, der RNFLT und der ChT wirksam sein.

Key words

congenital isolated growth hormone deficiency - recombinant growth hormone - retina nerve fiber layer thickness - spectral-domain optical coherence tomography

Schlüsselwörter

angeborener isolierter Wachstumshormonmangel - rekombinantes Wachstumshormon - Dicke der Nervenfaserschicht der Retina - optische Kohärenztomografie im Spektralbereich


Publication History

Received: 12 April 2022

Accepted: 07 February 2023

Article published online:
04 April 2023

© 2023. Thieme. All rights reserved.

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