Avaliação retiniana em adultos com deficiência isolada, congênita e vitalícia de hormônio do crescimento

Abstract

Context and objective: Experimental models demonstrate an important role of growth hormone (GH) in retinal development. However, the interactions between GH/IGF-I axis and the neuro-vascularization of the human retina are still not clear. A model of untreated congenital isolated GH deficiency (IGHD) may clarify the action of GH on the retina. The purpose of this work was to assess the retinal neuro-vascularization in adults with congenital IGHD. Methods: In a cross sectional study, we performed fundus photographs (to assess the number of retinal vascular branching points and the optic disc and cup size), and optical coherence tomography (to assess the thickness of macula) in 25 adults IGHD subjects (13 males, 50,9 yr. [12,0]) homozygous for a null mutation (c.57+1 G>A) in the GH releasing hormone receptor gene and 28 controls (14 males, 46,4 yr. [14,7]). Results: Fisher's exact test revealed that IGHD subjects presented more reduction of vascular branching points in comparison to controls (91% vs. 53% [p=0.049]). Conversely, the percentage of moderate reduction in IGHD was higher than in control (p=0,01). The rates of individuals with increased optic disc and cup size were increased in IGHD in comparison to controls (92,9% vs. 57,1 for optic disc and 92,9% vs. 66,7% for cup [p<0.0001 in both cases]). The percentage of increased optic disc and cup in IGHD was higher than in control (p=0,005 for optic disc and p=0,028 for cup). There was no difference in fovea thickness or in any of the macula areas. Conclusions: Most IGHD individuals present moderate reduction of vascular branching points, increase of optic disc and cup size, but equal thickness of the macula.