Growth hormone therapy and ocular biometry in paediatric growth hormone deficiency: a systematic review and...

Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) are essential regulators of somatic growth and may also influence ocular development, yet their effects on specific ocular biometric parameters remain insufficiently defined. This systematic review and meta-analysis investigated the impact of GH deficiency and GH replacement therapy on ocular outcomes in paediatric populations. A comprehensive search of PubMed, Embase, Web of Science, and Cochrane databases up to January 2025 identified randomised controlled trials, cohort studies, and case-control studies comparing ocular parameters between GH-treated individuals and healthy controls. Eight observational studies met inclusion criteria. Pooled analyses showed that GH therapy was significantly associated with increased intraocular pressure (mean difference [MD] 1.95 mmHg), central corneal thickness (MD 22.62 µm), and spherical equivalent (MD 0.45 dioptres), accompanied by reduced axial length (MD -0.94 mm), all reaching statistical significance. No meaningful differences were observed in refraction. Moderate to high heterogeneity was noted across some outcomes but improved substantially in leave-one-out sensitivity analyses, supporting the robustness of the findings. Overall, the results indicate that GH therapy produces measurable alterations in ocular parameters among children with GH deficiency, reinforcing the role of the GH-IGF-1 axis in ocular development and intraocular physiology. These findings underscore the importance of routine ophthalmologic monitoring in GH-treated patients and highlight the need for well-designed prospective studies to clarify long-term visual consequences and the clinical relevance of these biometric changes.