ESPE Abstracts (2018) 89 P-P2-215

Systematic Prospective Study of Eye Funduscopy Before and After Starting Treatment with Growth Hormone in 290 Patients

Mogas Eduarda,b, Martin Nievesa, Yeste Diegoa,b, Castaño Luisc, Clemente Maríaa,b, Campos Ariadnaa,b & Carrascosa Antonioa,b


aChildren’s University Hospital Vall Hebron, Barcelona, Spain; bAutonomous University of Barcelona, Barcelona, Spain; cCruces University Hospital, Barakaldo, Spain


Introduction: Idiopathic intracranial hypertension (IIH) is a rare entity in childhood. It is characterized by signs and symptoms of increased intracranial pressure with normal neurological examination (except for possible paresis of the sixth cranial nerve), cerebrospinal fluid study and neuroimaging. The association between HII and treatment with growth hormone (GH) was first described in 1993 by the Food and Drug Administration and it has later been demonstrated. Incidence varies between 0.025–0.03% of totality of treatments. It usually occurs a few weeks after the starting of treatment and its suspension reverses the symptomatology. The examination of eye funduscopy permits its diagnosis.

Material and methods: Prospective descriptive study performed by pediatric ophthalmologist. Examination of eye funduscopy before and 3 months after treatment with GH in patients with short stature and the following diagnoses: GH deficiency (n=238, 82%), of which idiopathic (IGHD) in 162 (55%) and associated with other diseases or comorbidities in 87 (30%), small for gestational age (n=33, 11%), Prader-Willy syndrome (n=3, 1%) and SHOX gene mutation (n=5, 1.7%).

Results: 308 patients were included; 290 completed follow-up. 4 patients (1.3%) presented papilledema after GH onset: 2 patients with GH deficiency in association with poly-malformation syndrome, 1 patient with panhypopituitarism due to a central nervous system tumor and 1 patient with IGHD and previous history of HII.

Conclusion: In asymptomatic IGHD patients without history of HII, we do not consider it necessary to performeye funduscopy examination after starting treatment with growth hormone.

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