Ocular morphology development and function in children with congenital hypothyroidism diagnosed by neonatal screening
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RESEARCH LETTER
Ocular morphology development and function in children with congenital hypothyroidism diagnosed by neonatal screening Angelo Tropeano1 Anna Maria Roszkowska2 Tommaso Aversa1 Domenico Corica1 Giorgia Pepe1 Pasquale Aragona3 Malgorzata Wasniewska 1 ●
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Received: 23 April 2020 / Accepted: 5 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
The ocular globe, as part of the central nervous system, is vulnerable to the lack of appropriate thyroid hormones (THs) levels especially during a period of active and rapid growth named “brain growth spurt”, which endures in early postnatal life [1]. In animal models of congenital hypothyroidism (CH), THs have shown a crucial function in craniofacial and eye development. In particular, corneal maturation, in terms of light transmission and epithelial development, as well as retinal thickness and layering, have been related to THs levels [1–5]. Long-term outcome of CH patients has been investigated mainly for auditory status [6–8], other aspects of health impairment have been studied little. In the current study, we have cross-sectionally investigated ocular morphology and function in a CH-selected population consisting of only screened and adequately substituted children with no underlying risk factors for visual pathology. This study aimed to evaluate whether ocular parameters are different in children with CH rather than the ones in healthy controls.
Materials and methods This cross-sectional study includes 32 caucasian CH patients (21 girls) who were diagnosed in 2 CH screening
* Malgorzata Wasniewska [email protected] 1
Department of Human Pathology of Adulthood and Childhood, Unit of Pediatrics, University of Messina, Messina, Italy
2
Ophthalmology Department, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kraków University, Kraków, Poland
3
Department of Biomedical Sciences, Ophthalmology Clinic, University of Messina, Messina, Italy
centers (Sicily and Calabria) during the period 1992–2006. The inclusion criteria were: being born adequate for gestation age; age at L-thyroxine (L-T4) therapy onset ≤30 days (median 28 days, range 7–30); initial L-T4 dose between 10 and 14 mcg/kg/day; thyrotropin (TSH) and free thyroxine (FT4) levels inside the normal range (0.3–5.0 mU/l and 12–22 pmol/l, respectively) from normalization due to L-T4 therapy start to the time of this study. The exclusion criteria included: transient CH; neonatal distress; severe prematurity; congenital infections; any organ malformations excluding thyroid gland; any congenital or acquired ocular pathology other than refractive error; the use of contact lenses; history of intraocular or refractive surgery; periocular or systemic steroid use within 3 months of enrollment. At confirmation of CH diagnosis, thyroid scanning had been performed by 99 m Technetium. CH-selected patients, at the median age of 15.4 years (range 8.0–22.0), underwent an ophthalmologic examination, including refractio
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