Şahin Muhammed, Şahin Alparslan, Kılınç Faruk, Yüksel Harun, Özkurt Zeynep Gürsel, Türkcü Fatih Mehmet, Pekkolay Zafer, Soylu Hikmet, Çaça İhsan
Department of Ophthalmology, School of Medicine, Dicle University, Diyarbakir, Turkey.
Department of Internal Medicine, Elazığ Training and Research Hospital, Elazıg, Turkey.
Int Ophthalmol. 2017 Jun;37(3):591-598. doi: 10.1007/s10792-016-0310-8. Epub 2016 Aug 4.
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.
肢端肥大症患者生长激素和胰岛素样生长因子-1分泌增加对多个器官有多种影响。然而,肢端肥大症的眼部影响尚未得到详细研究。本研究的目的是使用光谱域光学相干断层扫描(SD-OCT)比较肢端肥大症患者和健康对照者的视网膜神经节细胞/内丛状层(GCIPL)厚度和视乳头周围神经纤维层厚度(pRNFL)。这项横断面比较研究纳入了18例肢端肥大症患者和20例对照者。所有参与者均接受SD-OCT检查,以测量pRNFL(在七个视乳头周围区域)、GCIPL(在九个ETDRS区域)和中心黄斑厚度(CMT)。对肢端肥大症患者使用 Humphrey 视野分析仪进行视野(VF)检查。比较了肢端肥大症患者和对照者的测量结果。18例肢端肥大症患者的33只眼和20例对照者的40只眼符合本研究的纳入标准。肢端肥大症患者的总体计算平均pRNFL厚度显著低于对照者(P = 0.01),颞上象限和颞下象限的pRNFL厚度显著更低。与我们的预期相反,肢端肥大症患者和对照者鼻象限的pRNFL厚度相似。根据Spearman相关性分析,发现总体平均pRNFL厚度以及鼻上、鼻、鼻下和颞下象限的pRNFL厚度与平均偏差(MD)相关。然而,其他象限与VF敏感性无关。CMT值未观察到显著差异(P = 0.6)。肢端肥大症组内、外黄斑所有象限的GCIPL厚度均显著低于对照组,除了中央和外下象限(P < 0.05)。内、外黄斑下象限的GCIPL厚度与MD相关,而其他象限与VF敏感性之间未观察到相关性。我们证明,与对照者相比,肢端肥大症患者的GCIPL厚度降低。然而,与我们的预期相反,肢端肥大症患者鼻象限的pRNFL厚度相似。SD-OCT可能有助于评估肢端肥大症对视网膜结构的影响。