Introduction: Diabetic retinopathy (DR) is a vision threatening chronic microvascular complication of diabetes mellitus (DM). The potential roles of GH and insulin-like growth factor 1 (IGF1) in DR have been evaluated in vitro and in vivo. The present study aimed to assess the frequency and severity of retinopathy in acromegalic patients with various disease activity and glucose tolerance states (GTS).
Methods: All acromegalic patients followed in the outpatient Clinic of Endocrinology Departments of Baskent University Hospitals were included. Each patients fundoscopic examination was carried out by an experienced ophthalmologist in each center with a standard method. Acromegaly disease states were evaluated with basal GH and IGF1 measurements and GH measurement during an oral glucose tolerance test (OGTT) where appropriate. Glucose tolerance states were assessed with fasting and postprandial glucose, glycohemoglobin measurements and OGTT where appropriate. The relations between retina findings, disease activity, and GTS were examined.
Results: The study group comprised 41 acromegalic cases (20 females) with a mean age of 45.6±12.1 years. 25 patients had active disease with median GH level of 3.4 (0.729.6) ng/ml, IGF1 level of 475 (2031970) ng/ml, and median disease duration of 29 (3104) months. 16 patients had controlled disease with median GH level of 1.0 (0.172.5) ng/ml, IGF1 level of 162 (68.9348) ng/ml, and median disease duration of 40 (7420) months. 5 patients in the active disease group had DM of which two were uncontrolled. The biochemically controlled acromegaly group included 5 patients with controlled DM. Overall; one patient in the entire group had background retinopathy (2.4%).
Conclusion: Rarity of retinopathy including those with active acromegaly and uncontrolled DM may suggest that disease activity in acromegaly might not contribute to retinopathy.
30 Apr - 04 May 2011
European Society of Endocrinology