Restrictive extraocular myopathy: A presenting feature of acromegaly

Heireman, Steven; Delaey, Christophe; Claerhout, Ilse; Decock, Christian

doi:10.4103/0301-4738.86330

Cited by 14 publications

(8 citation statements)

References 9 publications

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“…3 Since that time, only 4 published studies demonstrated EOM enlargement in acromegaly and none included a control group. 4–7 Our study is the first to include a control group and has shown consistent EOM enlargement over a larger number of cases than all previously published cases combined.…”

Section: Discussionmentioning

confidence: 53%

Extraocular Muscle Enlargement in Acromegaly

McInnis¹,

Rjoob²,

Ohorodnyk³

et al. 2023

Journal of Neuro-Ophthalmology

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Background: To determine whether acromegaly is associated with increased extraocular muscle (EOM) size at time of presentation. Methods: Patients with a new diagnosis of acromegaly in a single tertiary care clinic with a CT scan that adequately delineated the EOMs were included. Control subjects were age- and sex-matched patients with a new diagnosis of nonfunctioning pituitary adenoma. Retrospective chart review was performed to extract baseline clinical and laboratory parameters including growth hormone, insulin-like growth factor 1, thyroid stimulating hormone, free T3, and free T4. A single neuroradiologist analyzed all CT scans and measured the maximum diameter and cross-sectional area of the superior rectus, inferior rectus, medial rectus, and lateral rectus in both eyes of all patients. Results: We evaluated 17 patients with acromegaly and 18 control subjects. Mean maximum diameter of the superior, inferior, medial, and lateral recti were 4.80 mm (SD = 0.81), 4.67 mm (SD = 0.54), 4.86 mm (SD = 0.77), and 4.53 mm (SD = 0.70) respectively, in the acromegaly group. In the control group, they were 3.62 mm (SD = 0.58),3.71 mm (SD = 0.46), 3.66 mm (SD = 0.32), and 3.21 mm (SD = 0.44), respectively. The maximum diameter and cross-sectional area of all 4 EOMs measured in the acromegaly group were significantly larger (P < 0.001) compared with the control group. Conclusions: Patients with acromegaly present with significantly enlarged EOMs compared with control subjects with nonfunctioning pituitary adenomas.

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Section: Discussionmentioning

confidence: 53%

Extraocular Muscle Enlargement in Acromegaly

McInnis¹,

Rjoob²,

Ohorodnyk³

et al. 2023

Journal of Neuro-Ophthalmology

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“…Orthoptic evaluation showed 10-prism diopter right eye hypotropia and 6-prism diopter right eye esotropia. [ 2 ] The elevation and abduction of the right eye were mechanically restricted. This was associated with systemic features and hormonal profile suggestive of acromegaly.…”

Section: Discussionmentioning

confidence: 99%

“…Proptosis and extraocular muscle involvement may occur with long standing GH excess. [ 2 3 4 5 ] We describe here two cases of female with acromegaly, who presented with bilateral epiphora as the presenting symptom.…”

Section: Introductionmentioning

confidence: 99%

Epiphora and proptosis as a presenting complaint in acromegaly: Report of two cases with review of literature

M¹,

Mohsin²,

Sharma³

et al. 2013

Indian J Endocr Metab

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Acromegaly is an endocrine disorder characterized by the excess of growth hormone leading to bony and soft-tissue enlargement. Eye involvement due to extraocular muscle enlargement has been described rarely in these patients. Epiphora has been described only once earlier in a patient with acromegaly. Here, we describe two females with acromegaly who presented with the complaints of watering from the eye and proptosis.

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“…Whereas acute muscle injury may cause increased irisin levels (48), several studies suggest a decrease in circulating irisin in chronic myopathies such as myotonic dystrophy (49), sarcopenia (50), and Cushing disease (51) or hypothyroidism (52)-associated myopathies. Until now, little attention has been paid to muscle disorders in acromegaly, but some research points toward the existence of myopathy connected with this disease, clinically manifesting as muscle weakness (53)(54)(55), diplopia (56), and muscle atrophy (55) with inhomogeneous pattern in muscle biopsy examination (57)(58)(59) and occasionally elevated creatine kinase or myopathic electromyography record (57,60). Impairment in muscle hormonal function in acromegaly would be the other side of the coin of this complication.…”

Section: Irisinmentioning

confidence: 99%

Myokines in Acromegaly: An Altered Irisin Profile

et al. 2021

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IntroductionThe muscle is an endocrine organ controlling metabolic homeostasis. Irisin and myostatin are key myokines mediating this process. Acromegaly is a chronic disease with a wide spectrum of complications, including metabolic disturbances.PurposeTo examine the influence of acromegaly on irisin and myostatin secretion and their contribution to metabolic profile and body composition.Materials and MethodsIn 43 patients with acromegaly and 60 controls, serum levels of irisin, myostatin, growth hormone (GH), insulin-like growth factor 1 (IGF-1), parameters of glucose, and lipid metabolism were determined. Body composition was assessed with dual-energy x-ray absorptiometry.ResultsThe irisin concentration was significantly lower in patients with acromegaly compared to controls (3.91 vs. 5.09 μg/ml, p = 0.006). There were no correlations between irisin and GH/IGF-1 levels. In the study group, irisin was negatively correlated with fasting insulin (r = −0.367; p = 0.042), HOMA-IR (r = −0.510; p = 0.011), and atherogenic factors: Castelli I (r = −0.416; p = 0.005), Castelli II (r = −0.400; p = 0.001), and atherogenic coefficient (AC) (r = −0.417; p = 0.05). Irisin and myostatin concentrations were also lower in acromegalics with insulin resistance than without (2.80 vs. 4.18 μg/ml, p = 0.047; 81.46 vs. 429.58 ng/L, p = 0.018, respectively). There were no differences between study group and controls in myostatin concentration. Myostatin levels negatively correlated with GH (r = −0.306; p = 0.049), HOMA-IR (r = −0.046; p = 0.411), and insulin levels (r = −0.429; p = 0.016).ConclusionsDecreased irisin concentrations in acromegaly may suggest impaired hormonal muscle function contributing to metabolic complications in this disorder. However, learning more about the association between myostatin and GH in acromegaly requires further studies. Nevertheless, it appears that myostatin is not critical for muscle mass regulation in acromegaly.

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Restrictive extraocular myopathy: A presenting feature of acromegaly

Cited by 14 publications

References 9 publications

Extraocular Muscle Enlargement in Acromegaly

Extraocular Muscle Enlargement in Acromegaly

Epiphora and proptosis as a presenting complaint in acromegaly: Report of two cases with review of literature

Myokines in Acromegaly: An Altered Irisin Profile

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