Posters

Evaluation of macular volume, retinal nerve fiber layer and choroidal thickness in acromegaly patients: a case control study

Poster Details

First Author: S. Yazgan TURKEY

Co Author(s): D. Arpaci   T. Celik                 

Abstract Details

Purpose:

Acromegaly is a chronic disease that results from a growth hormone (GH)-secreting pituitary adenoma. Growth hormone contributes to the development of the eye via autocrine, endocrine and paracrine effects. Growth factors were shown in vitreous and retina. The structure and physiology of the eye is affected in patients with acromegaly. In our study, we aimed to evaluate the effects of acromegaly on the structure of the retina. For this purpose, we measured various parameters including retinal volume, retinal nerve fiber thickness, macular and peripapillary choroidal thickness by optical coherence tomography and compared the results with healthy control subjects.

Setting:

This prospective, comparative, cross-sectional case-control study was conducted in Bulent Ecevit University, Ophthalmology department with the contribution of Internal Medicine, Endocrinology department in Zonguldak, Turkey. The study was conducted according to the Declaration of Helsinki and written informed consent was attained from each participant.

Methods:

This study included 31 unrelated patients with acromegaly and age- and sex-matched 32 healthy subjects. Choroidal thickness (CT), retinal nerve fiber layer(RNFL) and retinal volume analysis were performed by using spectral domain OCT. Only right eyes were evaluated. Macular CT was measured at three points including fovea and at 1mm distance along the temporal (TCT-1 mm) and nasal in the fovea (NCT-1mm). Peripapillary choroidal thickness (PPCT) was measured at 8 points. The macular volume measurements from the 9 areas of the macula were automatically performed by OCT. RNFL was measured automatically in OCT and measurements were performed at 6 segments.

Results:

Visual field was normal in all patients. Central corneal thickness was significantly higher in acromegaly group (p<0.001). Adjusted IOP value was not statistically different in two groups(p=0.065). All points of macular CT were significantly higher in acromegaly patients(p<0.001). Peripapillary CT were also higher in acromegaly group at the all measuring points(p<0.05). Peripapillary retinal nerve fiber layer were significantly higher in acromegaly group at the all measuring points (p<0.05). Total, inferior and superior zones of retinal volume of macular area were significantly higher in acromegaly group (p<0.05), however temporal, nasal and central zones of retinal volume were not statistically different (p>0.05).

Conclusions:

The macular and peripapillary CT, and retinal nerve fiber layer were significantly higher in acromegaly patients. Significant increase in retinal volume was observed in the acromegaly group in all zones except for central area, temporal 3 mm and 6 mm zones. Whether the cause of this increase is neurohyperthopic effect of intraretinal edema due to microvascular hyperpermeability could be the subject of further research. Increased choroidal thickness may cause different macular pathologies such as choroidal neovascularization. Retinal nerve fiber layer results may be important in acromegaly patients with glaucoma, especially if the progress of glaucoma is monitored by OCT.

Financial Disclosure:

None