Treatment with recombinant human growth hormone during childhood is associated with increased intraocular pressure

Objective: To evaluate the association between recombinant human growth hormone (rhGH) treatment and intraocular pressure (IOP) in children. Study design: This is an observational cohort study including comparison between children treated with rhGH for at least 12 months (treatment group), matched children prior to treatment (control group), and population age-adjusted normograms of IOP. All children underwent an ocular slit lamp assessment and Goldmann applanation tonometry. Charts were reviewed for cause of therapy, peak stimulated growth hormone level prior to therapy, treatment duration, insulin-like growth factor 1, and rhGH dosage. Results: The treatment group included 55 children and the control group included 24 children. Mean age at examination was comparable at 11.4 ± 3.3 years and 10.3 ± 2.6 years, respectively (P =.13). Mean treatment duration was 37.5 ± 22.8 months and mean rhGH dose was 0.04 ± 0.01 mg/kg/d. Mean IOP was significantly increased in the treatment group compared with the control group and compared with age-matched normograms (16.09 ± 2.2 mm Hg, 13.26 ± 1.83 mm Hg and 14.6 ± 1.97 mm Hg, respectively, P <.001). IOP was positively correlated with treatment duration (r = 0.559, P <.001) and rhGH dosage (r = 0.274, P =.043). Conclusion: IOP in children treated with rhGH is increased compared with a similar population without treatment and compared with healthy population normograms. IOP is associated with longer treatment duration and higher dosages.