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Meta-analysis finds growth hormone therapy shows no significant ocular biometric changes in idiopathic short statureGrowth hormone therapy shows possible link to refractive changes in children with short stature

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Key Takeaway
Consider that growth hormone therapy in idiopathic short stature shows no significant ocular biometric changes except refractive status, but evidence is inconsistent.

This is a systematic review and meta-analysis of nine studies examining the effects of growth hormone (GH) therapy on ocular structural and biometric parameters in children with idiopathic short stature. The primary outcomes were ocular structural parameters and biometric parameters, including corneal curvature, axial length, intraocular pressure, and refractive status.

The meta-analysis found no significant association between GH therapy and corneal curvature (SMD = 0.13; 95% CI: -0.34 to 0.61). There was no significant difference in axial length (MD = 0.72; 95% CI: -0.36 to 1.81) or intraocular pressure (MD = 1.38; 95% CI: -0.66 to 3.43). However, a significant association was found for refractive status (MD = 0.53; 95% CI: 0.20 to 0.86).

The authors noted substantial limitations, including high heterogeneity for axial length (I² = 91.7%) and intraocular pressure (I² = 95.9%). Results for these parameters were influenced by individual studies, and findings were inconsistent. Safety data were not reported.

The authors conclude that the associations between GH therapy and ocular biometric parameters in children with idiopathic short stature remain uncertain. The evidence is insufficient to recommend changes in clinical monitoring practice, and the findings should be regarded as hypothesis-generating.

Researchers combined data from nine different studies to look at how growth hormone therapy affects eye structure in children with idiopathic short stature. The group examined measurements like corneal curvature, axial length, and intraocular pressure alongside refractive status. They found no significant association with corneal curvature, axial length, or intraocular pressure. However, there was a significant association found with refractive status. The data showed high variation between the included studies, which makes the overall picture unclear.

There were no reported adverse events, serious issues, or discontinuations related to the therapy in these reports. Despite the lack of clear safety signals, the high inconsistency in the data limits what can be concluded. The uncertainty around axial length and pressure measurements means current monitoring practices should not change based on this evidence alone.

Readers should understand that while a possible link to refractive changes exists, the evidence is too inconsistent to be definitive. These results are considered hypothesis-generating rather than proof of harm or benefit. Doctors should continue to follow standard care while awaiting more consistent data from future research.

What this means for you:
Possible link to refractive changes found; no clear link to eye pressure or length; evidence remains inconsistent.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
This study aimed to conduct a systematic review and meta-analysis of the effects of growth hormone (GH) therapy on ocular structures and biometric parameters in children with idiopathic short stature (ISS), synthesizing existing evidence for future research. We systematically searched PubMed, EMBASE, the Cochrane Library, CNKI, Wanfang, and VIP databases from inception to September 2025. Randomized controlled trials and observational studies comparing the effects of GH therapy versus control on ocular biometric and refractive outcomes in children with ISS were included. Study quality was assessed using the Cochrane Risk of Bias Tool (RoB 2) and the NOS. Meta-analysis was performed using R software version 4.3.2, with effect sizes expressed as MD or SMD and 95% CI. Nine studies were included (4 RCTs, 5 cohort studies). Meta-analysis showed no significant association of GH therapy with corneal curvature (SMD = 0.13, 95% CI: -0.34 to 0.61). For axial length, the random-effects model showed no significant difference (MD = 0.72, 95% CI: -0.36 to 1.81), with high heterogeneity (I = 91.7%). Similarly, no significant association was found for intraocular pressure (MD = 1.38, 95% CI: -0.66 to 3.43; I = 95.9%). However, a significant association was observed for refractive status (MD = 0.53, 95% CI: 0.20 to 0.86; I = 0.0%). Sensitivity analysis showed robust results for corneal curvature and refractive outcomes, while axial length and intraocular pressure results were influenced by individual studies. Funnel plots and Egger's test indicated no significant publication bias.Conclusion: The associations between GH therapy and ocular biometric parameters in children with ISS remain uncertain. Current evidence suggests a possible link with refractive changes but shows no significant associations with axial length or intraocular pressure when accounting for high heterogeneity. The findings are inconsistent and should be regarded as hypothesis-generating, insufficient to recommend changes in clinical monitoring practice. Future large-sample, long-term studies are required.
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