Cornea in acromegalic patients as a possible target of growth hormone action.
BACKGROUND
GH exerts its effects on many organs and the eye also seems to be a target site, although few authors have investigated the corneal thickness in patients with acromegaly.


OBJECTIVE
To perform a detailed ophthalmological evaluation in acromegalic patients, in relation to disease activity.


METHODS
Twenty-eight acromegalic patients (11 males, 17 females) and 22 voluntary healthy subjects underwent complete metabolic and ophthalmological evaluation, including retinal thickness (RT), central corneal thickness (CCT), and intraocular pressure values (IOP).


RESULTS
Significantly greater CCT values were found in all acromegalic patients in comparison with controls (567 vs 528.5 μm; p<0.001), without concomitant greater corrected IOP. No difference was found for RT. Analyzing these data according to disease activity, uncontrolled patients showed greater CCT values (573.5 vs 559 μm; p=0.002) and corrected IOP (17.4 vs 16 mmHg; p=0.001) than the controlled ones. CCT also correlated with basal and nadir GH after oral glucose load levels, IGF-I levels, and duration of active disease.


CONCLUSIONS
Acromegaly is characterized by greater CCT values, supporting the hypothesis that GH excess may have stimulatory effects on the cornea as well as on other target organs. Higher GH levels, disease control status and duration of active disease seem to be the main causes of increased corneal thickness. We suggest a careful and detailed corneal evaluation in acromegalic patients to prevent the potential risk of increased IOP, in addition to the already-known complications.
Ciresi
A
A
Section of Endocrinology, Department of Experimental Oncology and Clinical Applications (DOSAC), Piazza delle Cliniche 2, 90127 Palermo, Italy.
Amato
M C
MC
Morreale
D
D
Lodato
G
G
Galluzzo
A
A
Giordano
C
C
D000172:Acromegaly / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D000818:Animals; D003315:Cornea / Q000033:anatomy & histology* / Q000473:pathology* / Q000502:physiology; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology; D008875:Middle Aged; D009798:Ocular Hypertension / Q000209:etiology
D019382:Human Growth Hormone