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Height and vision are undoubtedly two major concerns for parents. Almost every parent hopes that their child will be tall and have good eyesight. However, previous studies have confirmed that in both children and adults, taller individuals tend to have longer eye axes compared to their peers , and the growth of height and eye axis is positively correlated [1] .
That is to say, there is a certain correlation between rapid growth in height and accelerated growth of the eye axis , and as we all know, the rate of eye axis growth is a predictive indicator of myopia . But as shown in the figure, this process does not occur synchronously, but with a time lag of 1-2 years, that is the peak growth of the eye axis occurs first, and then the peak growth of height will follow .
Why does growth hormone
affect the development of the eyeball?
Growth hormone
(GH)
is a protein hormone secreted by the pituitary gland and is the key factor in regulating the height and growth of adolescents and children.
Why does growth hormone, in addition to promoting the growth of bones and muscles, also affect the development of the eyeball?
Since growth hormone is closely related to the growth of the eye axis, and as we all know, the rate of eye axis growth is a predictive indicator of myopia, it is inevitable to worry about
Will children treated with growth hormone injections
experience rapid growth of the eye axis?
A recent study may help us provide some ideas: myopic children do experience an increase in the rate of eye axis growth after undergoing growth hormone therapy (rhGH) . Studies have shown that growth hormone stimulates the secretion of insulin-like growth factor-1 （IGF-1） and the bone morphogenetic protein pathway, indirectly affecting the thickness of the sclera, thereby promoting the growth of the eye axis [2] .
Children receiving hormone injections
, their length growth is faster, with an average annual increase of 0.29mm;
Children not receiving hormone injections , the eyeball length increases by 0.18mm per year. [3]
What does this difference in the rate of eye axis growth mean? According to the “Expert Consensus on the Application of Axial Length in Myopia Control Management” (2023) , an annual increase in axial length of less than 0.2mm is considered to have a lower risk of myopia. The rate of eye axis growth in the non-hormone injection group is relatively safe, while the hormone injection group is just outside the safe range .
Due to the limited number of subjects included in this study (hormone injection group of 27 children, non-hormone injection group of 57 children) , and it is a retrospective study (the level of evidence is not too high) , so we can look forward to clinical studies with larger sample sizes and stronger research evidence .
Seeing this, parents may be in a dilemma again, on the one hand, they want their children to grow taller, on the other hand, they are worried about their children’s myopia .
Want children to grow taller, but also afraid of myopia,
what should we do?
The author’s suggestion is:
For children who indeed suffer from growth hormone deficiency and meet the indications for growth hormone therapy , do not arbitrarily stop treatment due to concerns about the growth of the eye axis. While persisting in treatment, strengthen myopia prevention and control measures;
For those who just want their children to grow taller , listen to the opinions of specialized doctors before deciding whether it is necessary to start treatment.
Reference popular science: “Is your child shorter than their peers? Do they need growth hormone? Here’s what you need to know”
A study found that children with growth hormone deficiency have shorter eye axes than normal children, are more likely to have hyperopia issues , and growth hormone therapy can promote their emmetropization , that is, the eye axis gradually increases, and the degree of hyperopia decreases. [4]
Therefore it is recommended to have an optometric development examination before starting growth hormone therapy .
If the child has hyperopia issues , then the growth of the eye axis after treatment is good news.
If the child has insufficient hyperopia reserve before treatment, is about to become myopic, or is already myopic , then it is necessary to pay more attention to the development of refraction after treatment and strengthen myopia prevention and control.
What methods can be used to prevent myopia if the child has already started growth hormone therapy?
For children who are not yet myopic
Reference popular science: “What can we do if our child is about to become myopic or wants to delay the onset of myopia?”
● At least have a vision check every 3 months ;
● Try to increase outdoor daytime activity time;
● Take necessary medical intervention measures (use orthokeratology lenses, special optical design glasses, low-concentration atropine and other preventive measures under the guidance of a doctor) .
For children who are already myopic
For children who are already myopic and undergoing growth hormone therapy, it is recommended to combine two medical intervention methods to enhance control effects.
Because the study found that even with one myopia control measure in place, the growth hormone group still had a faster eye axis growth than the non-injection group. However, with a combined control plan of optical + drug intervention measures (low-concentration atropine combined with OK lenses or specially designed myopia control glasses) , there was no statistical difference in the growth of the eye axis between the growth hormone group and the non-growth hormone group, which means the combined control plan is more rational.
In summary, although growth hormone injections can cause the eye axis to grow faster, whether it will cause myopia or not still needs to be considered comprehensively based on the child’s refractive status before treatment and the myopia prevention measures taken.
Peer review expert Zhang Yingying
Distinct Eye Doctor
Ph.D. from Sun Yat-sen University中山医学院
References
Content Editor LEE
