Increased prevalence of proliferative retinopathy in patients with acromegaly

J Chin Med Assoc. 2018 Mar;81(3):230-235. doi: 10.1016/j.jcma.2017.09.013. Epub 2017 Dec 2.

Abstract

Background: This pilot study was carried to determine the prevalence of retinopathy, especially proliferative retinopathy, in patients with acromegaly.

Methods: We analyzed 43 acromegalic patients and 129 age- and gender-matched patients with type 2 diabetes. The retinopathy status was determined from the medical records based on the ophthalmologist consultations of patients with acromegaly. Color photographs of the macula- and disc-centered views were obtained at an angle of 45° with a fundus camera after pharmacologic-induced mydriasis in patients with type 2 diabetes.

Results: Compared with age- and gender-matched patients with type 2 diabetes, the acromegalic patients had lower fasting plasma glucose levels and lower systolic and diastolic blood pressures, but were taller and had higher IGF-1 levels. Any degree of retinopathy was present in 9.3% (4 of 43) of patients with acromegaly and 34.9% (45 of 129) of patients with type 2 diabetes (odds ratio [OR] = 0.191; 95% confidence interval [CI] = 0.064-0.570). Proliferative retinopathy was present in 9.3% (4 of 43) of patients with acromegaly and 9.3% (12 of 129) of patients with type 2 diabetes (OR = 1.000; 95% CI = 0.305-3.281). Non-proliferative retinopathy was absent in patients with acromegaly, but present in 25.9% (33 of 129) of patients with type 2 diabetes.

Conclusion: The high proliferative, but absence of non-proliferative retinopathy in our patients with acromegaly may reflect the pathogenic effect of IGF-1 on neovascularization. IGF-1 may play an important role in proliferative retinopathy, but may play no role in non-proliferative retinopathy.

Keywords: Acromegaly; Growth hormone; IGF-1; Proliferative retinopathy.

MeSH terms

  • Acromegaly / blood
  • Acromegaly / complications*
  • Adult
  • Aged
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Retinopathy / blood
  • Diabetic Retinopathy / epidemiology*
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Insulin-Like Growth Factor I / analysis
  • Insulin-Like Growth Factor I / physiology
  • Male
  • Middle Aged
  • Pilot Projects
  • Prevalence

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human
  • Insulin-Like Growth Factor I