Endocrine Abstracts

Introduction: Acromegaly is a rare disease with an insidious course characterized by several complications that determine its prognosis. This is a case study about 76 patients treated at CHU Ibn Rochd to evaluate the ophthalmological impact of this disease.

Material and methods : This is a retrospective study of 76 cases of acromegaly followed in the endocrinology department of Ibn Rochd University Hospital from January 2005 to October 2023. All our patients benefited from an ophthalmological evaluation and visual field. The statistical analysis was done by EXCEL software.

Results: The average age was 49 years with a sex ratio F/M of: 0.33. The average BMI rate was 29 kg/m² with overweight in 12 patients (20.8%), and obesity in 23 patients (41.6%). The average duration of the disease was 9 and a half years; The average IGF1 level was 2.3 times normal and the etiological diagnosis was a pituitary adenoma in all patients. Pituitary tumor syndrome (THS) (96%) and acro -facial dysmorphia (93%) were the main reasons for consultation. Visual disturbances linked to STH were noted in 50% of our patients, including blindness (n=2), diplopia (n=9) and visual blur (n=38). A decrease in visual acuity was observed in 91.2%. Ophthalmological examination detected papillary pallor in 30%, glaucoma in 6.5% and diabetic retinopathy in 7.8%. The visual field showed bitemporal hemianopia in 40.35%, diplopia in 1.75%, amputation of the visual field in 10.52%, a slight bitemporal deficit in 14.9%, a slight peripheral deficit in 8, 77% Bitemporal hemianopia and visual field amputation were the most common visual field alterations

Discussion: Somatotropic adenomas are characterized by an insidious evolution and a generally late diagnosis during a tumor syndrome and visual disturbances which reflect tumor invasion at the expense of the cavernous sinus and the optical pathways.

Conclusion: Preserving the visual prognosis remains one of the major objectives of treatment. It is therefore important to evaluate the visual impact by an ophthalmological and visual field examination during the initial diagnosis and during the follow-up of acromegaly. Close collaboration between endocrinologist, neurosurgeon and ophthalmologist is necessary.