IGF-1 IS AN INDEPENDENT PREDICTOR OF RETINAL ARTERIES REMODELING IN SUBJECTS WITH UNCONTROLLED ACROMEGALY.Eur J Endocrinol 2020EJ
Cardiovascular disease is one of the main causes of morbidity in active acromegaly due to the increased prevalence of risk factors and arterial consequences of increased growth hormone levels. No in vivo study has evaluated the consequences of acromegaly on the retinal microvasculature.
The aim of this study was to identify in vivo the presence of morphological alterations of retinal arterioles in subjects with acromegaly.
PATIENTS AND METHODS
Single-center retrospective study of a cohort of 60 subjects with acromegaly, matched to 60 controls, who were referred for Adaptive Optics Camera (AOC) from September 2014 to December 2016. Among subjects with acromegaly 19 had an Active Disease (AD) and 41 a controlled disease (CD) according to IGF-1 ratio (IGF-1r). Retinal arteriolar remodeling was previously assessed using Adaptive Optics Camera (AOC) in order to measure wall to lumen ratio (WLR), wall thickness (WT), internal diameter (ID) and wall cross sectional area (WCSA).
WLR was significantly higher in AD subjects compared to CD subjects and Controls (AD: 0.311±0.06, CD: 0.279±0.04, Controls: 0.281±0.04, p=0.031). A significant positive correlation was observed between WLR and IGF-1r (R2=0.215, p<0.001), even after adjustment for gender, age, Systolic Blood Pressure (SBP) and the presence of dopamine agonist treatment (R2=0.406, p<0.001). Retinal arteriolar anatomical indices were comparable between CD and controls.
Active acromegaly is associated with the presence of small retinal arteriolar remodeling. These results provide new perspectives to better stratify cardiovascular risk and consequently optimize treatment in acromegaly.