Session: Poster session C

Extraocular muscle enlargement in acromegaly patients.

Introduction:

Acromegaly is a rare disease, its annual incidence is 3-4/1 000 000 people. In more than 95% of patients the cause is a growth hormone (GH)-secreting pituitary adenoma. Increased levels of GH and insulin-like growth factor (IGF-1) stimulate the growth of various epithelial and connective tissues. Our objective is to evaluate the extraocular muscles(EOM) through imaging studies in patients diagnosed with acromegaly.

 

Methods:

We carried out a retrospective study of patients diagnosed with pituitary adenoma and acromegaly, between 2014 and 2022 at the Ribera POVISA Hospital. We reviewed the imaging tests performed to study the pituitary gland.

For the analysis of EOM thickening, the diameter of the medial and inferior rectus was measured. The measurements were obtained by computed tomography (CT) in one case, and by magnetic resonance imaging (MRI) in the other 3 patients. We compared the measurements obtained with control values ​​from healthy patients described in the literature.

 

Results:

A total of 4 patients were included, 2 of whom were men. The average age of the subjects was 52.25±8.18 years. We found thickening of the EOM in 3 of the 4 cases analyzed. There was asymmetry for the medial rectus, with greater thickening in the right compared to the left, although we did not obtain significant differences.

 

Conclusions:

Thickening of EOM associated with acromegaly has been described, although literature is limited to case series.

Knowing this association will avoid performing unnecessary diagnostic tests in search of other pathologies that cause EOM thickening. The limitations of this study are mainly its retrospective nature with brain and pituitary imaging studies, which lack the resolution of orbital studies. On the other hand, the sample is very small, although this is related to the low prevalence of the pathology. We had this finding in 3 of 4 patients.