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Reduced Retinal Vascularization in Children with Growth Hormone Deficiency¹

Department of Clinical Neuroscience’s, Section of Ophthalmology, International Pediatric Growth Research Center, Department of Pediatrics, Research Center for Endocrinology and Metabolism, Department of Internal Medicine, University of Goteborg; and the Biostatistics Branch, Department of Mathematical Statistics, Chalmers University of Technology, Göteborg, Sweden

Address all correspondence and requests for reprints to: Ann Hellström, M.D., Ph.D., Section of Pediatric Ophthalmology, Sahlgrenska University Hospital/Östra, S-416 85 Göteborg, Sweden. E-mail: ann.hellstrom{at}medfak.gu.se

The neovascularization in diabetic retinopathy is believed to involve locally produced angiogenic factors. In addition, there are indications that GH may influence retinal vascularization. To investigate the role of GH in retinal vascularization, we examined the retinal vascular pattern in children with congenital GH deficiency. Retinal vessel morphology was evaluated by digital image analysis of ocular fundus photographs in 39 children (5 girls and 34 boys, aged 3.6–18.7 yr) with congenital GH deficiency, and it was compared to that of 100 healthy controls. Twenty children had received GH treatment (0.1 IU/kg daily). All children were born at term, and none of the children had any clinical signs of ocular disease or reduced vision. Children with GH insufficiencies, regardless of whether they were treated with GH, had a significantly lower number of vascular branching points than the reference group (P < 0.0001). Thirty-three percent of the GH-insufficient individuals had a number of vascular branching points less than or equal to the fifth percentile of the reference group. The reduced retinal vascularization observed in children with congenital GH deficiency suggests that GH may be of importance for angiogenesis.

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