| Objective: To explore the characteristics of ocular biological parameters in children with short stature aged 3 to 14 and analyze the correlation between parameters and height,and compare the height and ocular biological parameters of short stature children receiving treatment of recombinant human growth hormone(rh GH),short stature children not receiving treatment and healthy children before and after 6 and 12 months of follow-up,so as to further evaluate the effect of rh GH on ocular development.Methods: This study was prospective.From July 2021 to July 2022,82 children aged 3to 14 who were diagnosed as short stature in the Growth and development Clinic of the First Affiliated Hospital of Anhui Medical University in Hefei,Anhui Province,were included as the short group.Among them,24 children(48 eyes)who received rh GH treatment were included as the treatment group(44 eyes of 22 patients followed up for 6months,36 eyes of 18 patients followed up for 12 months),and 34 children(68 eyes)who did not receive treatment were included in the same region as the non-treatment group(36 eyes of 18 patients followed up for 6 months,36 eyes of 18 patients followed up for 12 months).The children in the treatment group received rh GH injection daily according to the dosage.In the same period,130 healthy children matched in age and gender were included as the control group(102 eyes of 51 cases followed up for 6months,78 eyes of 39 cases followed up for 12 months).All subjects underwent refractive questionnaire and measured their visual acuity,intraocular pressure(IOP),axial length(AL),average corneal curvature(CC),corneal astigmatism(AST),central corneal thickness(CCT),anterior chamber depth(ACD),lens thickness(LT)and white-to-white distance(WTW)were measured before and after 6 and 12 months of follow-up,as well as calculating the axial length / corneal radius ratio(AL/CR ratio).Two independent sample t and Mann Whitney U tests were used to compare the parameters of children in the short group and the control group.Pearson correlation and simple linear regression were used to analyze the relationship between biological parameters of eye and height.One-way analysis of variance and Kruskal Wallis H tests were used to compare the parameters of children in the treatment group,non-treatment group and control group before and after the follow-up and between different genders,LSD and Bonferroni tests were used to pairwise compare among three groups.Result:1.The AL and ACD of children in the short group were(22.70±0.77)mm and(2.89±0.30)mm,respectively,which were lower than those in the control group(23.02±0.67)mm and(2.98±0.27)mm,with statistically significant differences(t=-3.161,-2.296;P=0.002,0.023).The CC of the short group was(43.44±1.03)D,higher than that of the control group(43.10±1.06)D,with a statistically significant difference(t=2.292;P=0.023).The AL,AL/CR ratio and ACD of male in the short group were higher than those of female,with statistically significant differences(F=8.869,9.445,9.777;P<0.05).The AL and CCT of male in the control group were higher than those of female,with statistically significant differences(F=6.099,5.643;P=0.015,0.019).The AL(r=0.569,0.753;P<0.001),AL/CR ratio(r=0.558,0.711;P<0.001)and ACD(r=0.450,0.516;P<0.001)of children in the short group and control group were positively correlated with height,while LT was significantly negatively correlated with height(r=-0.454,-0.527;P<0.001).2.The increase in height of children in the treatment group at 6 and 12 months of follow-up was(5.84±1.95)cm and(11.58±3.06)cm,respectively,which was higher than that in the non-treatment group(3.83±1.55)cm and(5.88±1.63)cm,as well as in the control group(3.73±1.89)cm and(7.60±2.72)cm,with statistically significant differences(H=36.500,53.522;P<0.001).3.The increase in AL and AL/CR ratio of children in the treatment group after 12 months of follow-up was(0.28±0.21)mm and(0.03±0.06),which was smaller than that of the control group(0.39±0.18)mm and(0.05±0.03),and the difference was statistically significant(F=4.756;P=0.010).The changes in AL and AL/CR ratio in the treatment group for male at 6 and 12 months of follow-up were higher than those in female,with statistically significant differences(Z=-3.138,t=5.053,Z=-3.088,-3.449;P<0.05)4.At 6-month follow-up,the IOP in the treatment group was greater than the baseline value,the difference was statistically significant(H=8.066;P=0.018),and the increase was(1.57±2.29)mm Hg,which was greater than the decrease in the non-treatment group and the control group,the difference was statistically significant(H=30.960;P<0.001).The increase in CCT in the treatment group after 6months of follow-up was(3.07±6.07)μm,which was greater than in the control group(0.62±6.24)μm,and the difference was statistically significant(H=6.113;P=0.047).The CCT of children in the treatment group increased with the increase of follow-up period,the increase value was(3.07±6.07)μm at 6 months of follow-up,greater than the control group(0.62±6.24)μm,with statistically significant difference(H=6.113;P=0.047).5.The increase in ACD in the treatment group after 12 months of follow-up was(0.10±0.14)mm,which was greater than that of the control group(0.03±0.1)mm,with a statistically significant difference(H=9.154;P=0.010).The decrease in LT in the control group after 12 months of follow-up was(-0.02±0.13)mm,which was smaller than that in the treatment group(-0.09±0.16)mm and the non-treatment group(-0.08±0.19)mm,with a statistically significant difference(H=9.483;P=0.009).The overall changes in CC,AST,and WTW were relatively small before and after follow-up in the three groups.Conclusion:1.Short stature children have larger CC,shorter AL,and shallower ACD compared to healthy children,suggesting that children with short stature should regularly check their eye conditions to avoid the risk of diseases such as hyperopia,strabismus,keratoconus,and glaucoma,especially in female.2.Rh GH has a significant promoting effect on children’s height,but it has inhibitory effect on the development of AL and refraction,and there are differences between male and female.On the one hand,the rapid increase in height is not the reason for the development of refraction towards myopia,in other words,there may be different mechanisms for the ocular development and the change of height,and sex hormones may be involved.On the other hand,this provides new ideas for controlling the increase of refraction.3.Rh GH has a promoting effect on IOP,CCT,ACD,and LT in children,causing increase in IOP,CCT,and ACD while decrease in LT,indicating that rh GH has a positive impact on ocular development and suggests a potential risk of glaucoma.Regular follow-up of IOP should be noted for short stature children receiving treatment. |
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