Ocular findings in Sheehan's syndrome

Graefes Arch Clin Exp Ophthalmol. 2015 May;253(5):759-63. doi: 10.1007/s00417-014-2916-8. Epub 2015 Jan 10.

Abstract

Background: Sheehan's syndrome (SS) is one of the most common causes of hypopituitarism. The primary effect of SS is a deficiency in production of growth hormone (GH). A number of studies have supported the association between congenital GH deficiency and ocular anomalies. However, ocular findings such as central corneal thickness (CCT), intraocular pressure (IOP), and retinal nerve fiber layer thickness (RNFLT) have not been evaluated in patients with adult GH deficiency. The objective of this study was to evaluate ocular anomalies in SS with GH deficiency under a cross-sectional design.

Methods: Thirty three SS patients with GH deficiency and 28 controls with no history of thyroid, adrenal, or pituitary gland diseases or surgery underwent complete hormonal and ophthalmological evaluation, including an assessment of CCTs, IOPs, and RNFLT.

Results: The mean CCTs were significantly lower in the SS group compared with the control group (p < 0.001). There was no significant difference between patients and controls in terms of mean IOP, mean corrected IOP, and mean RNFLT (p = 0.517, p = 0.186, p = 0.965, respectively). The mean CCT was positively correlated with insulin-like growth factor 1 (IGF-1; p < 0.01) and adrenocorticotropic hormone (ACTH; p < 0.01) and negatively correlated with the corrected mean IOP (p < 0.05). In covariance analysis, IGF-1 was found to be a potential predictor of the mean CCT (p = 0.023).

Conclusions: This study is the first investigation of ocular findings in SS and adult GH deficiency. Adult GH deficiency is characterized by lower CCT values.

MeSH terms

  • Adrenocorticotropic Hormone / blood
  • Aged
  • Cornea / pathology*
  • Corneal Diseases / diagnosis
  • Corneal Diseases / physiopathology*
  • Corneal Pachymetry
  • Cross-Sectional Studies
  • Female
  • Growth Hormone / deficiency*
  • Humans
  • Hypopituitarism / physiopathology*
  • Insulin-Like Growth Factor I / metabolism
  • Intraocular Pressure / physiology*
  • Middle Aged
  • Nerve Fibers / physiology
  • Organ Size
  • Retinal Ganglion Cells / physiology
  • Tomography, Optical Coherence

Substances

  • Insulin-Like Growth Factor I
  • Adrenocorticotropic Hormone
  • Growth Hormone