Endocrine Abstracts

Introduction: Acromegaly is a rare, complex condition that throughout its evolution affects the body on numerous levels, especially if inappropriately managed. Some of the complications it develops over time are ophthalmic, neurological and psychiatric.

Aim: The aim is to asses the impact of long-term acromegaly on the eye, nervous system and mental health of previously diagnosed patients.

Patients and method: 90 patients’ records (mean age 53.91 years) with previously diagnosed acromegaly, who have been assessed at least once in our tertiary referral centre (Department of Endocrinology, University Hospital ‘Sfântul Spiridon’, Iaşi) over a period of 7 years have been reviewed.

Results: Out of the 90 assessed patients (33 male - 36.66% and 57 female - 63.33%), 26 (28.88%) had opthalmic complications, 11 (12.22%) had neurological complications and 17 (18.88%) were diagnosed with psychiatric conditions in the context of the endocrine alterations caused by the disease. The diagnosed ophthalmic complications are as follows: partial optic atrophy in 7 patients (26.92%), total optic atrophy in 5 patients (19.23%), temporal hemianopsia in 2 patients (7.69%), quadrantanopia has been also found in 2 patients (7.69%), retinal angiosclerosis in 2 patients (7.69%), the presence of scotoma has been determined in 2 patients (7.69%), diabetic retinopathy in 2 patients (7.69%), hypertensive retinopathy grade 1 in 3 patients (11.53%), and grade 2 in 5 patients (19.23%), glaucoma in 1 patient (3.84%) and cataract in 2 patients (7.69%). Neurology-wise, a history of stroke has been reported in 4 patients (36.36%), facial palsy in 1 patient (9.09%), peripheral neuropathy has been diagnosed in 4 subjects (36.36%) and grand mal seizures in 2 individuals (18.18%). When it comes to psychiatric manifestations associated with endocrine diseases, anxiety was reported in 13 patients (76.47%), depression in 5 patients (29.41%) and delusional disorder in 1 subject (5.88%).

Conclusions: The present research has offered insight into the ophthalmic and neuropsychiatric complications frequently associated with the development of acromegaly, thus reiterating the need of an interdisciplinary approach to these patients, in order to insure correct diagnosis and treatment and an improved quality of life.

Key words: acromegaly, opthalmic complications, neuropsychiatric complications