Growth Hormone Therapy And Ocular Growth In Children: A Prospective Study Of Refraction And Axial Length

To evaluate the effect of growth hormone (GH) replacement therapy on refractive and biometric ocular parameters in children. GH influences somatic growth and may modulate ocular development through IGF-1–mediated mechanisms affecting axial elongation and the emmetropization process. Clinical evidence in pediatric populations remains limited. Given concerns regarding accelerated somatic growth and potential ocular elongation, understanding the ocular effects of GH therapy is clinically relevant. This study assessed whether GH therapy is associated with short-term changes in refraction and axial length in a prospective pediatric cohort.

Prospective observational study conducted in a tertiary multidisciplinary pediatric endocrine-ophthalmology setting.

Prospective longitudinal study including children aged 7-13 years receiving GH therapy and age-matched controls. Comprehensive ophthalmologic assessment included standardized cycloplegic refraction, slit-lamp and fundus examination, corneal topography, and optical biometry for axial length (AL) measurement. All examinations were performed by a single masked examiner using the same device. GH-treated patients were reassessed after six months. Intergroup comparisons used independent t-tests; longitudinal changes were analyzed using paired tests (p<0.05).

Twelve children were included (mean age 10.5±1.8 years; 16.7% male). Anterior and posterior segment exams were normal in all participants. No significant intergroup differences were observed in corneal astigmatism in the right eye (OD) and left eye (OS) (p=0.915 and p=0.992, respectively). Mean axial length (AL) did not differ between GH-treated and controls (OD 22.17±0.66 vs 23.4±1.4 mm, p=0.088; OS 22.17±0.72 vs 23.3±1.4 mm, p=0.108). In longitudinal analysis of GH-treated patients, corneal parameters remained stable (OD p=0.584; OS p=0.975). AL remained stable in the right eye (22.13±0.64 vs 22.17±0.66 mm, p=0.101) but increased in the left eye (22.11±0.71 vs 22.17±0.72 mm, p=0.021). No refractive changes were observed during follow-up.

Short-term GH therapy was not associated with relevant refractive or biometric changes. A small unilateral axial increase was detected, but of uncertain clinical significance. These findings suggest a limited short-term impact of GH on ocular growth and support periodic ophthalmologic monitoring in treated children. Larger studies with longer follow-up are needed to clarify potential cumulative effects on refractive development.