Growth hormone replacement therapy is not associated with retinal changes

GH and/or growth factors are thought to play a role in the pathogenesis of diabetic retinopathy. In addition, the occurence of retinal changes mimicki ng diabetic retinopathy in two GH-deficient (GHD) patients receiving GH rep lacement therapy (GHRT) has recently been reported. The present study was p erformed to evaluate whether this was a coincidence or whether GHRT might r egularly induce retinal changes. Sixty-one GHD patients on GHRT with a mean age of 42.5 +/- 17.3 yr were examined by one ophthalmologist (AR). The mea n duration of GHRT was 8.4 +/- 3.7 yr in childhood onset and 3.5 +/- 2.1yr in adult onset patients. Plasma insulin-like growth factor I concentrations were 76.4 +/- 49.6 ng/mL before GHRT and 244.3 +/- 119.2 ng/mL while recei ving GHRT with a dose of 1.7 +/- 0.7 IU/day. After pupil dilatation with tr opicamide, fundus examinations of both eyes were performed using a Volk 90 diopter fundus lens with a slit lamp (Haag Streit, Bern, Switzerland). In n one of the patients were vascular or retinal changes like macular edema, mi croaneurysms, hemorrhages, hard exsudates, cotton wool spots, preproliferat ive signs, or proliferations found. The optic discs were also normal in all patients. We conclude, therefore, that long-term GHRT can be administered safely in GHD patients without an increased risk of retinal changes.