Assessment of Retinal and Choroidal Structure in Children Receiving Growth Hormone Replacement Therapy for Isolated Growth Hormone Deficiency.

Abstract

Purpose: To evaluate retinal parameters and choroidal structural changes in children with isolated growth hormone deficiency (IGHD) and compare them with healthy children, and to find out whether these parameters are affected by growth hormone replacement therapy.

Methods: A total of 56 patients diagnosed as having IGHD were included in the study. The control group consisted of 46 healthy children, carefully matched for age and sex, with no systemic or ocular problems. All patients and controls underwent enhanced depth imaging optical coherence tomography to measure the central macular thickness (CMT), retinal nerve fiber layer (RNFL) thickness, subfoveal choroidal thickness (SFCT), choroidal luminal area, stromal area, and the total area. Choroidal vascular index (CVI) was calculated as the ratio of luminal area to total choroidal area.

Results: No statistically significant difference was observed between the groups in terms of age, gender, axial length, best corrected visual acuity, and intraocular pressure (P > .50). There were no significant differences in CMT and RNFL thickness between the study and control groups (P = .91 and .78, respectively). However, mean SFCT was significantly lower in the study group (333.7 ± 37.9 µm) than in the control group (351.2 ± 34.3 µm) (P = .01). Similarly, luminal area, total choroidal area, and CVI were significantly lower in the study group than in the control group (P < .05). Although no significant change was observed in CMT and RNFL thickness 12 months after growth hormone replacement therapy in the study group (P > .05), a significant increase was noted in SFCT, luminal area, total choroidal area, and CVI (P < .05).

Conclusions: This study shows that patients with IGHD have lower SCT and CVI values compared to healthy children. Growth hormone treatment appears to be associated with choroidal development.