Corneal Tonometric and Morphological Changes in Patients with Acromegaly

Izabela Skrzypiec; Joanna Wierzbowska; Maria Sobol; Grzegorz Zieliński

doi:10.3390/jcm11226750

Corneal Tonometric and Morphological Changes in Patients with Acromegaly

J Clin Med. 2022 Nov 15;11(22):6750. doi: 10.3390/jcm11226750.

Authors

Izabela Skrzypiec¹, Joanna Wierzbowska¹, Maria Sobol², Grzegorz Zieliński³

Affiliations

¹ Department of Ophthalmology, Military Institute of Medicine-National Research Institute, 128 Szaserow Str, 04-141 Warsaw, Poland.
² Department of Biophysics, Physiology and Pathophysiology, Medical University of Warsaw, 5 Chalubinskiego Str, 02-004 Warsaw, Poland.
³ Department of Neurosurgery, Military Institute of Medicine-National Research Institute, 128 Szaserow Str, 04-141 Warsaw, Poland.

Abstract

(1) Purpose: This study aimed to investigate the changes in Reichert Ocular Response Analyzer (ORA) parameters, corneal endothelium parameters, central corneal thickness (CCT), and intraocular pressure (IOP) before and after the transsphenoidal resection of pituitary adenoma in patients with acromegaly. (2) Methods: This was a single-center, prospective, interventional study. Twenty patients with newly diagnosed acromegaly were examined before and 19 ± 9 months after transsphenoidal resection. The participants underwent a comprehensive ophthalmological examination including pneumatic IOP (IOP air puff), Goldmann applanation tonometry (IOP GAT), CCT measured using the iPac pachymeter (CCT_UP), IOP value corrected for CCT_UP using the Ehlers formula (IOPc) ORA measurements included corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated IOP (IOPcc), and Goldmann-correlated IOP (IOPg). CCT from non-contact specular microscopy (CCT_NSM), the number of endothelial cells (CD) per mm2, and average cell size (AVG) were determined with non-contact specular microscopy. (3) Results: A statistically significant decrease was observed in CCT_UP (p = 0.007), and IOP air puff (p = 0.012) after surgery. Moreover, we noted a statistically significant increase in CD (p = 0.001), and a statistically significant decrease in AVG (p = 0.009) and CCT_NSM (p = 0.004) after surgery. A statistically significant decrease was also observed in IOPg (p = 0.011), CH (p = 0.016), and CRF (p = 0.001) after surgery. The mean value of IOP GAT and IOPc was lower after the surgery. However, the difference was not statistically significant. (4) Conclusions: Our study revealed significant changes in biomechanics, corneal endothelium, CCT and IOP after pituitary adenoma resection in patients with acromegaly. It proves that the eye might be sensitive to long-term overexposure to growth hormone (GH) and insulin-like growth factor-1 (IGF-1). We suggest that disease activity be taken into consideration on ophthalmological examination.

Keywords: acromegaly; anterior eye segment; cornea; corneal endothelium; growth hormone; intraocular pressure; tonometry.

Grants and funding

WIM/MNiSW grant No. 453/WIM/Wojskowy Instytut Medyczny