关键词: 近视, 眼球发育, 矮小症, 重组人生长激素, 眼生物学指标

Abstract: Objective To explore the effect of recombinant human growth hormone (rhGH) on eye development in children with myopia and dwarfism under the background of secondary sexual characteristics. Design Case-control study. Participants Sixty children (120 eyes) with dwarfism in the age stage of secondary sexual characteristics admitted to Ziyang Central Hospital from February 2021 to May 2024, while 60 children with normal development were set as the normal control group. Methods Sixty children (120 eyes) with dwarfism were randomly divided into treatment group and observed group. The treatment group received rhGH intervention for growth and development. The changes in height, growth hormone (GH), serum insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), and ocular biological indicators [including corneal curvature(CC), spherical equivalent (SE), astigmatism (AST), axial length (AL), anterior chamber depth (AD), vitreous thickness (VT)] were compared and analyzed before and after treatment for 1 and 2 years. Main Measure Outcomes Height, GH, IGF-1, IGFBP-3, and ocular biological indicators. Results Before treatment, the average height, IGF-1, GH, and IGFBP-3 of children in the dwarfism group were significantly lower than those in the normal control group (all P<0.05); Pearson correlation analysis and linear regression analysis showed that CC (r=0.681, 0.375; P=0.001, 0.003), SE (r=0.474, 0.427; P=0.007, 0.003), AST (r=0.392, 0.394; P=0.002, 0.001), AL (r=0.369, 0.369; P=0.003, 0.001), AD (r=0.385, 0.275; P=0.017, 0.001), and VT (r=0.175, 0.258; P=0.003, 0.021) were positively correlated with height in both the dwarfism group and the normal control group of children. After 1 and 2 years of treatment with rhGH, the height, IGF-1, GH, and IGFBP-3 of the treatment group significantly increased (all P<0.05). The increase in height after 2 years was (27.53±3.02) cm, which was significantly higher than that of the non treatment group (17.14±1.95 cm) (P=0.001). Compared with baseline, the CC, SE, AL, AD and VT of children in the treatment group, non treatment group, and normal control group increased at 1-year and 2-year follow-up, and the differences were statistically significant (all P<0.05). The SE increases in the treatment group, non treatment group, and normal control group at 1-year follow-up were (0.87±0.13) D, (0.33±0.07) D and (0.32±0.09) D, respectively, and at 2-year follow-up were (1.72±0.49) D, (0.54±0.12) D and (0.79±18) D, respectively. The annual increase in AL was (0.64±0.12) cm, (0.22±0.06) cm and (0.33±0.09) cm, respectively. The two-year increase in AL was (1.17±0.28) cm, (0.51±0.13) cm, and (0.56±0.15) cm, respectively (all P<0.05). In addition, at the 1-year and 2-year follow-up time points, compared with the non treatment group, the increase in CC, AST, AD, and VT in the treatment group was consistent with the trend of SE and AL changes, and the differences were statistically significant (all P<0.05). Conclusion rhGH therapy can accelerate the progression of myopia in dwarfism children under the background of secondary sexual characteristics. For such patients, close monitoring of ocular biological indicators is essential to prevent excessive axial length growth and to implement timely myopia prevention measures.

Key words: Myopia, Ocular development, Dwarfism, Recombinant human growth hormone, Eye biological indicators