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Growth Hormone Replacement Therapy Is Not Associated with Retinal Changes

Department of Medicine III, Division of Endocrinology and Metabolism (D.B., M.R., M.C., A.L.), and Departments of Ophthalmology (A.R.) and Pediatrics (H.F.), University of Vienna; and Department of Medicine 1, Hospital Rudolfstiftung (C.S., G.S.), 1090 and 1030 Vienna, Austria

Address correspondence and requests for reprints to: Anton Luger, M.D., Department of Medicine III, Division of Endocrinology and Metabolism, University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. E-mail: anton.luger{at}akh-wien.ac.at

GH and/or growth factors are thought to play a role in the pathogenesis of diabetic retinopathy. In addition, the occurence of retinal changes mimicking diabetic retinopathy in two GH-deficient (GHD) patients receiving GH replacement therapy (GHRT) has recently been reported. The present study was performed to evaluate whether this was a coincidence or whether GHRT might regularly induce retinal changes. Sixty-one GHD patients on GHRT with a mean age of 42.5 ± 17.3 yr were examined by one ophthalmologist (AR). The mean duration of GHRT was 8.4 ± 3.7 yr in childhood onset and 3.5 ± 2.1yr in adult onset patients. Plasma insulin-like growth factor I concentrations were 76.4 ± 49.6 ng/mL before GHRT and 244.3 ± 119.2 ng/mL while receiving GHRT with a dose of 1.7 ± 0.7 IU/day. After pupil dilatation with tropicamide, fundus examinations of both eyes were performed using a Volk 90 diopter fundus lens with a slit lamp (Haag Streit, Bern, Switzerland). In none of the patients were vascular or retinal changes like macular edema, microaneurysms, hemorrhages, hard exsudates, cotton wool spots, preproliferative signs, or proliferations found. The optic discs were also normal in all patients. We conclude, therefore, that long-term GHRT can be administered safely in GHD patients without an increased risk of retinal changes.

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