Retina ganglion cell/inner plexiform layer and peripapillary nerve fiber layer thickness in patients with acromegaly

Abstract

Increased secretion of growth hormone and insulin-like growth factor-1 in acromegaly has various effects on multiple organs. However, the ocular effects of acromegaly have yet to be investigated in detail. The aim of the present study was to compare retina ganglion cell/inner plexiform layer (GCIPL) and peripapillary nerve fiber layer thickness (pRNFL) between patients with acromegaly and healthy control subjects using spectral domain optical coherence tomography (SD-OCT). This cross-sectional, comparative study included 18 patients with acromegaly and 20 control subjects. All participants underwent SD-OCT to measure pRNFL (in the seven peripapillary areas), GCIPL (in the nine ETDRS areas), and central macular thickness (CMT). Visual field (VF) examinations were performed using a Humphrey field analyzer in acromegalic patients. Measurements were compared between patients with acromegaly and control subjects. A total of 33 eyes of 18 patients with acromegaly and 40 eyes of 20 control subjects met the inclusion criteria of the present study. The overall calculated average pRNFL thickness was significantly lower in patients with acromegaly than in control subjects (P = 0.01), with pRNFL thickness significantly lower in the temporal superior and temporal inferior quadrants. Contrary to our expectations, pRNFL thickness in the nasal quadrant was similar between acromegalic and control subjects. The mean overall pRNFL thickness and superonasal, nasal, inferonasal, and inferotemporal quadrant pRNFL thicknesses were found to correlate with the mean deviation (MD) according to Spearman's correlation. However, other quadrants were not correlated with VF sensitivity. No significant difference in CMT values was observed (P = 0.6). GCIPL thickness was significantly lower in all quadrants of the inner and outer macula, except for central and inferior outer quadrants, in the acromegaly group than that in the control group (P< 0.05). GCIPL thicknesses of the inferior inner and outer macula quadrants were found to correlate with MD, whereas no correlation was observed between other quadrants and VF sensitivity. We demonstrated that GCIPL thickness decreased in patients with acromegaly compared with that in control subjects. However, the nasal quadrant pRNFL thickness was similar in acromegaly, in contrast to our expectations. SD-OCT may have utility in the assessment of the effects of acromegaly on retinal structures.

Evaluation of the retinal layers and microvasculature in patients with acromegaly: a case-control OCT angiography study

“…In contrast, Yazgan et al reported increment in RNFL thickness in each quadrant [6]. However, Şahin et al reported decreased RNFL thickness in inferotemporal and superotemporal quadrants [8]. In our study, there was a decrease in RNFL thickness in the inferior and superior quadrants.…”

“…In addition, similar to the results in this study, when Duru et al examined the relationship between serum IGF-1 levels and RNFL thickness, they found no correlation [12]. Şahin et al reported an increase in GC-IPL thickness [8]. In the present study, GC-IPL thickness did not differ between the groups.…”

“…In ocular tissues, growth in extraocular muscles [3], increase in intraocular pressure (IOP) [4], and increase in corneal thickness [5] have been shown previously. Also retinal thickness increase [6], increase in choroidal thickness [7], ganglion cell complex (GCC) thickness reduction [8][9][10][11][12], retinal nerve fibre layer (RNFL) thickness increase [6]/ decrease [4,12], and increase in the incidence of proliferative retinopathy [13] have been shown previously by using optic coherence tomography (OCT) and fundus fluorescein angiography.…”

Utility of Optical Coherence Tomography in the Diagnosis and Management of Optic Neuropathy in Patients with Fibrous Dysplasia

“…Previous studies have demonstrated that acromegalic patients with macroadenomas have decreased RNFL thickness due to chiasmal compression. ( 43–45 ) However, Yazgan and colleagues recently showed that acromegalic patients without macroadenomas have increased RNFL thickness, suggesting growth hormone excess has a protective effect on the neural retinal layers in the absence of compression. However, untreated growth hormone excess is an established risk factor of ON in FD/MAS, ( 11 ) which may be due to stretch/traction of the optic nerve in the setting of macrocephaly, or compression of the nerve or chiasm by expanded FD or macroadenomas, respectively.…”

Optical coherence tomography in patients with somatotropin-producing pituitary adenoma

“…Şahin и соавт. [42] обследовали 18 пациентов (33 глаза) с соматотропиномой гипофиза при помощи SD-OCT. Общая средняя толщина RNFL в перипапиллярной области у пациентов была меньше, чем в группе контроля (p = 0,01), более выраженное снижение толщины RNFL выявлено в верхневисочных и нижневисочных квадрантах. Толщина GCC сетчатки, включая внутренний плексиформный слой (GCIPL), во всех квадрантах внутреннего и внешнего колец по сетке ETDRS, за исключением центрального и нижневисочного квадрантов, у пациентов была меньше, чем в контроле (p < 0,05).…”